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General NPI Number Information
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NPI Number | 1760360705
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Entity Type | Organization
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Legal Business Name | DENTOLOGIE, LLC
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 15729 OLD COLUMBIA PIKE
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1030
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Country | US
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Telephone | 240-800-2000
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Fax | 240-800-2001
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Provider Business Mailing Address
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Address Line | 21307 DENIT ESTATES DR
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City | BROOKEVILLE
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State | MD
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Zip | 20833-1837
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Country | US
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Telephone | 301-661-5138
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAMS UL ISLAM
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Credential | DDS
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Telephone | 301-661-5138
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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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