| Dental Office | |
|
8819 Woodyard Rd Clinton MD 20735 | |
| (301) 877-2600 | |
| (301) 877-2603 |
| Full Name | Dental Office |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8819 Woodyard Rd, Clinton, Maryland |
| Authorized Official Name and Position | Tyrus G Montgomery (DENTIST) |
| Authorized Official Contact | 3018772600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Office 8819 Woodyard Rd Clinton MD 20735 Ph: (301) 877-2600 | Dental Office 8819 Woodyard Rd Clinton MD 20735 Ph: (301) 877-2600 |
| NPI Number | 1619004108 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619004108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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