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4959 Westview Dr Suite F Frederick MD 21703-7369 | |
| (301) 363-1211 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4959 Westview Dr, Frederick, Maryland |
| Authorized Official Name and Position | Brittany Nichelle Howard (CREDENTIALING AFFILIATION COORDINAT) |
| Authorized Official Contact | 2175908946 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1200 Network Centre Drive Suite #2 Effingham IL 62401 Ph: (217) 540-8946 | 4959 Westview Dr Suite F Frederick MD 21703-7369 Ph: (301) 363-1211 |
| NPI Number | 1902339062 |
|---|---|
| Provider Enumeration Date | 04/06/2017 |
| Last Update Date | 08/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902339062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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