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General NPI Number Information
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NPI Number | 1598369563
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Entity Type | Organization
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Legal Business Name | CONNECTION DENTAL LLC
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 1131 UNIVERSITY BLVD W STE 103
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City | SILVER SPRING
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State | MD
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Zip | 20902-3338
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Country | US
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Telephone | 202-257-2205
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Fax |
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Provider Business Mailing Address
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Address Line | 8455 FENTON ST APT 309
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City | SILVER SPRING
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State | MD
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Zip | 20910-5013
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Country | US
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Telephone | 202-257-2205
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. TIFFANY ASHTON
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Credential | DDS
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Telephone | 202-257-2205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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