| Clarksburg Dental Center Llc | |
|
23212 Brewers Tavern Way Clarksburg MD 20871-4391 | |
| (301) 515-5525 | |
| (301) 515-9339 |
| Full Name | Clarksburg Dental Center Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 23212 Brewers Tavern Way, Clarksburg, Maryland |
| Authorized Official Name and Position | Edmund Y Liu (DENTIST) |
| Authorized Official Contact | 3015155525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarksburg Dental Center Llc 23212 Brewers Tavern Way Clarksburg MD 20871-4391 Ph: (301) 515-5525 | Clarksburg Dental Center Llc 23212 Brewers Tavern Way Clarksburg MD 20871-4391 Ph: (301) 515-5525 |
| NPI Number | 1861569485 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861569485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 13060 (Maryland) | Primary |
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Clarksburg Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 23212 Brewers Tavern Way, Clarksburg, MD 20871 Phone: 301-515-5525 |