MEDICARE: TOTAL YOU FAMILY DENTISTRY

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
1	1223G0001X	General Practice Dentistry	15806	MD

General Provider Information

NPI Number	:	1811427677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL YOU FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	9135 PISCATAWAY RD STE 105
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-2548
Country	:	US
Telephone Number	:	240-348-7860
Fax Number	:	240-348-7861

Provider Business Practice Location Address
First Line	:	9135 PISCATAWAY RD STE 105
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-2548
Country	:	US
Telephone Number	:	240-348-7860
Fax Number	:	240-348-7861

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. AMOS WILLIAMS
Credential	:
Telephone Number	:	240-348-7860

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	07/21/2022

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Directions to “TOTAL YOU FAMILY DENTISTRY ” Practice Location

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