| Russell Park Dental Care, Llc | |
|
963 Russell Ave Ste A Gaithersburg MD 20879-3287 | |
| (301) 284-8467 | |
| Not Available |
| Full Name | Russell Park Dental Care, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 963 Russell Ave Ste A, Gaithersburg, Maryland |
| Authorized Official Name and Position | Vigen Simchian (MEMBER) |
| Authorized Official Contact | 3012848467 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Park Dental Care, Llc 963 Russell Ave Ste A Gaithersburg MD 20879-3287 Ph: (301) 284-8467 | Russell Park Dental Care, Llc 963 Russell Ave Ste A Gaithersburg MD 20879-3287 Ph: (301) 284-8467 |
| NPI Number | 1407474380 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 07/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407474380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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