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General NPI Number Information
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NPI Number | 1730726449
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Entity Type | Organization
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Legal Business Name | SAMMY NOUMBISSI DDS PA
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Dates
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Enumeration Date | 12/02/2019
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 801 WAYNE AVE STE G200
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City | SILVER SPRING
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State | MD
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Zip | 20910-4450
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Country | US
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Telephone | 301-588-0768
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Fax | 240-839-5008
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Provider Business Mailing Address
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Address Line | 801 WAYNE AVE STE G200
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City | SILVER SPRING
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State | MD
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Zip | 20910-4450
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Country | US
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Telephone | 301-588-0768
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Fax | 240-839-5008
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMMY NOUMBISSI
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Credential | DDS
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Telephone | 301-588-0768
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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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