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NPI Code Detail

MEDICARE: DENTISTRY FOR CHILDREN OF MARYLAND, LLC

MEDICARE: DENTISTRY FOR CHILDREN OF MARYLAND, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1609335066
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTISTRY FOR CHILDREN OF MARYLAND, LLC
Provider Business Mailing Address
First Line : 2970 BRANDYWINE RD STE 200
Second Line :
City : ATLANTA
State : GA
Zip : 30341-5549
Country : US
Telephone Number : 770-692-1000
Fax Number :
Provider Business Practice Location Address
First Line : 8600 SNOWDEN RIVER PKWY STE 302
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-1985
Country : US
Telephone Number : 410-953-0111
Fax Number :
Authorized Official
Title or Position : CREDENTIALING DIRECTOR
Name : JO ANN RICE
Credential :
Telephone Number : 470-881-8679
Provider Enumeration Date : 03/15/2019
Last Update Date : 11/28/2025

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Directions to “DENTISTRY FOR CHILDREN OF MARYLAND, LLC ” Practice Location

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