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General NPI Number Information
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NPI Number | 1972853661
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Entity Type | Individual
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Provider Name | CHARLIE CAGE DDS
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Gender | Female
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 08/24/2019
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Provider Practice Location Address
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Address Line | DENTAL CORPS PROGRAMS CODE 1WPGDC 8955 WOOD RD
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City | BESTHESDA
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State | MD
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Zip | 20889-5628
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Country | US
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Telephone | 301-295-0650
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Fax |
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Provider Business Mailing Address
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Address Line | DENTAL CORPS PROGRAMS CODE 1WPGDC 8955 WOOD ROAD
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City | BETHESDA
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State | MD
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Zip | 20889-5628
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Country | US
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Telephone | 301-295-0650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7020
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License Number State | NE
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