| Modern Smile Dental | |
|
901 Russell Ave Ste 100 Gaithersburg MD 20879-3281 | |
| (301) 977-8640 | |
| Not Available |
| Full Name | Modern Smile Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 901 Russell Ave Ste 100, Gaithersburg, Maryland |
| Authorized Official Name and Position | Michelle Janbakhsh (DENTIST) |
| Authorized Official Contact | 2024093178 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Smile Dental 11801 Kigger Jack Ln Clarksburg MD 20871-9310 Ph: (202) 409-3178 | Modern Smile Dental 901 Russell Ave Ste 100 Gaithersburg MD 20879-3281 Ph: (301) 977-8640 |
| NPI Number | 1629732300 |
|---|---|
| Provider Enumeration Date | 10/28/2021 |
| Last Update Date | 10/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629732300 | NPI | - | NPPES |
| 027383000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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