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General NPI Number Information
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NPI Number | 1881441236
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Entity Type | Organization
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Legal Business Name | ROSE PARK PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 05/03/2024
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 2440 M ST NW STE 315
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City | WASHINGTON
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State | DC
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Zip | 20037-1449
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Country | US
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Telephone | 202-873-9696
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Fax | 202-816-7759
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Provider Business Mailing Address
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Address Line | 5200 PRINCETONS DELIGHT DR
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City | BOWIE
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State | MD
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Zip | 20720-6345
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Country | US
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Telephone | 202-805-9493
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | AVIONNE HILL
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Credential | DDS
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Telephone | 202-873-9696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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