| Smile Loft Branch Ave Llc | |
|
4710 Auth Pl Suitland MD 20746-4223 | |
| (301) 899-1188 | |
| Not Available |
| Full Name | Smile Loft Branch Ave Llc |
|---|---|
| Speciality | Dentist |
| Location | 4710 Auth Pl, Suitland, Maryland |
| Authorized Official Name and Position | Kashyap D. Patel (DENTIST) |
| Authorized Official Contact | 3018991188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Loft Branch Ave Llc 4710 Auth Pl Suitland MD 20746-4223 Ph: () - | Smile Loft Branch Ave Llc 4710 Auth Pl Suitland MD 20746-4223 Ph: (301) 899-1188 |
| NPI Number | 1114322658 |
|---|---|
| Provider Enumeration Date | 10/27/2014 |
| Last Update Date | 10/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114322658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 15582 (Maryland) | Primary |
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