| Fort Davis Dental Associates, Pllc | |
|
2300 Good Hope Rd Se Suite 3 Washington DC 20020-5147 | |
| (202) 889-8200 | |
| (202) 889-5891 |
| Full Name | Fort Davis Dental Associates, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2300 Good Hope Rd Se, Washington, District Of Columbia |
| Authorized Official Name and Position | Isaiah Purnell Morrison (PRESIDENT) |
| Authorized Official Contact | 2028898200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Davis Dental Associates, Pllc 2300 Good Hope Rd Se Suite 3 Washington DC 20020-5147 Ph: (202) 889-8200 | Fort Davis Dental Associates, Pllc 2300 Good Hope Rd Se Suite 3 Washington DC 20020-5147 Ph: (202) 889-8200 |
| NPI Number | 1386917755 |
|---|---|
| Provider Enumeration Date | 02/16/2012 |
| Last Update Date | 02/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386917755 | NPI | - | NPPES |
| 021929400 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DEN3045 (District Of Columbia) | Primary |
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