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General NPI Number Information
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NPI Number | 1407712177
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Entity Type | Organization
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Legal Business Name | SMILING OUT LOUD ORTHODONTICS
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 113 LA GRANGE AVE
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City | LA PLATA
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State | MD
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Zip | 20646-9592
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Country | US
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Telephone | 832-721-0393
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Fax |
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Provider Business Mailing Address
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Address Line | 113 LA GRANGE AVE
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City | LA PLATA
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State | MD
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Zip | 20646-9592
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Country | US
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Telephone | 832-721-0393
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MOSHOOD MARTINS
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Credential | DDS
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Telephone | 832-721-0393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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