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1026 16th St Nw Ste 105 Washington DC 20036-5711 | |
| (202) 737-7025 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1026 16th St Nw Ste 105, Washington, District Of Columbia |
| Authorized Official Name and Position | Ivory Hancock (DENTIST/OWNER) |
| Authorized Official Contact | 2027377025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1026 16th St Nw Ste 105 Washington DC 20036-5711 Ph: (202) 737-7025 | 1026 16th St Nw Ste 105 Washington DC 20036-5711 Ph: (202) 737-7025 |
| NPI Number | 1134608581 |
|---|---|
| Provider Enumeration Date | 08/07/2018 |
| Last Update Date | 08/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134608581 | NPI | - | NPPES |
| 100722 | Other | DC | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 100722 (District Of Columbia) | Primary |
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