| Shadygrove Dental Center | |
|
14955 Shady Grove Rd Ste 360 Rockville MD 20850-8719 | |
| (301) 610-7724 | |
| Not Available |
| Full Name | Shadygrove Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 14955 Shady Grove Rd Ste 360, Rockville, Maryland |
| Authorized Official Name and Position | Fabiana Raquel Offit (OWNER) |
| Authorized Official Contact | 3016107724 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadygrove Dental Center 14955 Shady Grove Rd Ste 360 Rockville MD 20850-8719 Ph: (301) 610-7724 | Shadygrove Dental Center 14955 Shady Grove Rd Ste 360 Rockville MD 20850-8719 Ph: (301) 610-7724 |
| NPI Number | 1508076787 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508076787 | NPI | - | NPPES |
| 1093875833 | Other | MD | INDIVIDUAL NPI# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 10551 (Maryland) | Primary |
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