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General NPI Number Information
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NPI Number | 1962365288
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Entity Type | Organization
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Legal Business Name | SILVERSPOON DENTAL AND ASSOCIATES
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 12300 KEMMERTON LN
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City | BOWIE
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State | MD
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Zip | 20715-2721
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Country | US
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Telephone | 301-262-1888
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Fax | 301-262-1899
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Provider Business Mailing Address
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Address Line | 12300 KEMMERTON LN
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City | BOWIE
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State | MD
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Zip | 20715-2721
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Country | US
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Telephone | 301-262-1888
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Fax | 301-262-1899
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Authorized Official
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Title or Position | DENTIST
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Name | DR. TYRUS G MONTGOMERY
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Credential | DMD
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Telephone | 301-266-1888
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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 |
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License Number State |
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