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8630 Fenton St 708 Silver Spring MD 20910-3806 | |
| (240) 839-5100 | |
| (240) 839-5101 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 8630 Fenton St, Silver Spring, Maryland |
| Authorized Official Name and Position | Kyiah Danelle Gill (OFFICE MANAGER) |
| Authorized Official Contact | 2408395100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8630 Fenton St 708 Silver Spring MD 20910-3806 Ph: (240) 839-5100 | 8630 Fenton St 708 Silver Spring MD 20910-3806 Ph: (240) 839-5100 |
| NPI Number | 1972949535 |
|---|---|
| Provider Enumeration Date | 05/22/2013 |
| Last Update Date | 08/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972949535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 14056 (Maryland) | Primary |
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