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General NPI Number Information
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NPI Number | 1730896374
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Entity Type | Organization
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Legal Business Name | ONE SMILE AT A TIME, LLC
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Dates
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Enumeration Date | 11/02/2022
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 15638 LIVINGSTON RD STE 9
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City | ACCOKEEK
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State | MD
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Zip | 20607-3340
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Country | US
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Telephone | 925-219-2859
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Fax |
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Provider Business Mailing Address
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Address Line | 15638 LIVINGSTON RD STE 9
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City | ACCOKEEK
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State | MD
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Zip | 20607-3340
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Country | US
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Telephone | 925-219-2859
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. IFEOMA ESSIEN
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Credential | DDS
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Telephone | 925-219-2859
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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 |
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License Number State |
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