| Oxon Hill Smiles Youth Dentistry, Pc | |
|
30 Audrey Ln Suite A Oxon Hill MD 20745-1301 | |
| (301) 567-5437 | |
| (301) 567-5456 |
| Full Name | Oxon Hill Smiles Youth Dentistry, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 30 Audrey Ln, Oxon Hill, Maryland |
| Authorized Official Name and Position | Jenell Stump (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 6157500343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oxon Hill Smiles Youth Dentistry, Pc 16 Arcade Unit 198747 Nashville TN 37219-1994 Ph: (615) 750-0343 | Oxon Hill Smiles Youth Dentistry, Pc 30 Audrey Ln Suite A Oxon Hill MD 20745-1301 Ph: (301) 567-5437 |
| NPI Number | 1861685554 |
|---|---|
| Provider Enumeration Date | 08/25/2007 |
| Last Update Date | 07/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861685554 | NPI | - | NPPES |
| 413913500 | Medicaid | MD | |
| 038809900 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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