| Stellar Dental, Llc | |
|
11239 Lockwood Dr Silver Spring MD 20901-4554 | |
| (301) 753-1900 | |
| Not Available |
| Full Name | Stellar Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 11239 Lockwood Dr, Silver Spring, Maryland |
| Authorized Official Name and Position | Allen Gotora (CEO) |
| Authorized Official Contact | 2022030230 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stellar Dental, Llc 5105 Griffendale Ln Upper Marlboro MD 20772-3180 Ph: (202) 203-0230 | Stellar Dental, Llc 11239 Lockwood Dr Silver Spring MD 20901-4554 Ph: (301) 753-1900 |
| NPI Number | 1902202211 |
|---|---|
| Provider Enumeration Date | 11/13/2014 |
| Last Update Date | 10/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902202211 | NPI | - | NPPES |
| 199657 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 14124 (Maryland) | Primary |
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