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NPI Code Detail

MEDICARE: FAMILY DENTAL CARE LLC

MEDICARE: FAMILY DENTAL CARE 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 : 1649861188
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY DENTAL CARE LLC
Provider Business Mailing Address
First Line : 7063 ALLENTOWN RD
Second Line :
City : TEMPLE HILLS
State : MD
Zip : 20748-5301
Country : US
Telephone Number : 301-449-1088
Fax Number : 301-449-3924
Provider Business Practice Location Address
First Line : 7063 ALLENTOWN RD
Second Line :
City : TEMPLE HILLS
State : MD
Zip : 20748-5301
Country : US
Telephone Number : 301-449-1088
Fax Number : 301-449-3924
Authorized Official
Title or Position : DENTIST
Name : DR. ISIS MASSOUD
Credential : DDS
Telephone Number : 301-449-1088
Provider Enumeration Date : 01/28/2021
Last Update Date : 01/28/2021

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Directions to “FAMILY DENTAL CARE LLC ” Practice Location

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