| Ortho Suite Llc | |
|
5642 Shields Dr Bethesda MD 20817-3573 | |
| (301) 363-9026 | |
| Not Available |
| Full Name | Ortho Suite Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 5642 Shields Dr, Bethesda, Maryland |
| Authorized Official Name and Position | Derek Blank (PRESIDENT) |
| Authorized Official Contact | 9493025146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ortho Suite Llc 5642 Shields Dr Bethesda MD 20817-3573 Ph: (301) 363-9026 | Ortho Suite Llc 5642 Shields Dr Bethesda MD 20817-3573 Ph: (301) 363-9026 |
| NPI Number | 1013596964 |
|---|---|
| Provider Enumeration Date | 04/07/2021 |
| Last Update Date | 04/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013596964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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