| Department Of Dentistry | |
|
111 Michigan Ave Nw Washington DC 20010-2916 | |
| (202) 476-6706 | |
| Not Available |
| Full Name | Department Of Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 111 Michigan Ave Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Phillicia Nelson (EXEC DIR-PAYOR FINANCIAL RELATIONS) |
| Authorized Official Contact | 3015726281 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Department Of Dentistry Po Box 745842 Atlanta GA 30374-5842 Ph: () - | Department Of Dentistry 111 Michigan Ave Nw Washington DC 20010-2916 Ph: (202) 476-6706 |
| NPI Number | 1275860637 |
|---|---|
| Provider Enumeration Date | 11/05/2009 |
| Last Update Date | 10/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275860637 | NPI | - | NPPES |
| 028002700 | Medicaid | DC | |
| 760664800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | HFD01-0208 (District Of Columbia) | Primary |
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