| Lifetime Dental Care Of Maryland, Badger, P.c. | |
|
11721 Woodmore Rd 170 Mitchellville MD 20721-4117 | |
| (301) 218-4110 | |
| (310) 218-4120 |
| Full Name | Lifetime Dental Care Of Maryland, Badger, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 11721 Woodmore Rd, Mitchellville, Maryland |
| Authorized Official Name and Position | Brittany Nichelle Howard (CREDENTIALING AFFILIATION COORDINAT) |
| Authorized Official Contact | 2175408946 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Dental Care Of Maryland, Badger, P.c. 1200 Network Centre Drive Suite #2 Effingham IL 62401 Ph: (217) 540-8946 | Lifetime Dental Care Of Maryland, Badger, P.c. 11721 Woodmore Rd 170 Mitchellville MD 20721-4117 Ph: (301) 218-4110 |
| NPI Number | 1972713352 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972713352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 07158 (District Of Columbia) | Primary |
| 1223G0001X | Dentist - General Practice | 10283 (District Of Columbia) | Secondary |
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