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General NPI Number Information
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NPI Number | 1790148419
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Entity Type | Organization
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Legal Business Name | TOTAL DENTAL CARE
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 20680 SENECA MEADOWS PKWY SUITE 218
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City | GERMANTOWN
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State | MD
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Zip | 20876-7022
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Country | US
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Telephone | 301-928-6890
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Fax |
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Provider Business Mailing Address
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Address Line | 20680 SENECA MEADOWS PKWY SUITE 218
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City | GERMANTOWN
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State | MD
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Zip | 20876-7022
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Country | US
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Telephone | 301-928-6890
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Fax |
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Authorized Official
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Title or Position | MANAGING OWNER
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Name | DR. MARY BOWERS ALEXANDER
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Credential |
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Telephone | 301-928-6890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10598
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License Number State | MD
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