| Dc Dental Specialty Center, Pc | |
|
3946 Minnesota Ave Ne Washington DC 20019-2661 | |
| (202) 397-1033 | |
| (202) 397-2104 |
| Full Name | Dc Dental Specialty Center, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3946 Minnesota Ave Ne, Washington, District Of Columbia |
| Authorized Official Name and Position | Jenell Stump (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 6157500343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dc Dental Specialty Center, Pc 16 Arcade Unit 198747 Nashville TN 37219-1994 Ph: (615) 750-0343 | Dc Dental Specialty Center, Pc 3946 Minnesota Ave Ne Washington DC 20019-2661 Ph: (202) 397-1033 |
| NPI Number | 1205140514 |
|---|---|
| Provider Enumeration Date | 07/28/2010 |
| Last Update Date | 07/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205140514 | NPI | - | NPPES |
| 207659 | Other | MD | DENTAQUEST |
| 057227600 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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