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General NPI Number Information
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NPI Number | 1396299574
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Entity Type | Organization
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Legal Business Name | COLUMBIA DENTAL CLINIC INC
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 08/05/2016
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Provider Practice Location Address
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Address Line | 2440 M ST NW 202
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City | WASHINGTON
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State | DC
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Zip | 20037-1404
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Country | US
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Telephone | 202-296-8383
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Fax | 202-296-9898
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Provider Business Mailing Address
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Address Line | 2440 M ST NW 202
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City | WASHINGTON
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State | DC
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Zip | 20037-1404
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Country | US
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Telephone | 202-296-8383
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Fax | 202-296-9898
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Authorized Official
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Title or Position | DENTIST/ OWNER
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Name | ANWAR SALHA
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Credential | DMD
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Telephone | 202-296-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5763
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License Number State | DC
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