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451 Hungerford Dr Ste 100 Rockville MD 20850-5102 | |
| (240) 381-7814 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 451 Hungerford Dr Ste 100, Rockville, Maryland |
| Authorized Official Name and Position | Carolyn Soojin Chang (MANAGING MEMBER) |
| Authorized Official Contact | 2403817814 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3517 Doc Berlin Dr Silver Spring MD 20906-1151 Ph: (240) 381-7814 | 451 Hungerford Dr Ste 100 Rockville MD 20850-5102 Ph: (240) 381-7814 |
| NPI Number | 1083192884 |
|---|---|
| Provider Enumeration Date | 08/02/2018 |
| Last Update Date | 08/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083192884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 14020 (Maryland) | Primary |
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