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General NPI Number Information
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NPI Number | 1780080424
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Entity Type | Organization
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Legal Business Name | DENTAL LAND PEDIATRICS LLC
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Dates
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Enumeration Date | 11/07/2014
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 6842A RACE TRACK RD
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City | BOWIE
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State | MD
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Zip | 20715-3011
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Country | US
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Telephone | 301-262-9800
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Fax | 240-334-2031
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Provider Business Mailing Address
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Address Line | 6842A RACE TRACK RD
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City | BOWIE
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State | MD
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Zip | 20715-3011
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Country | US
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Telephone | 301-262-9800
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Fax | 240-334-2031
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Authorized Official
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Title or Position | PEDIATRIC DENTIST/OWNER
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Name | DR. DINAH ABIORO
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Credential | DDS
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Telephone | 301-262-9800
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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 | 14427
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License Number State | MD
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