| Water Brook Dental | |
|
2750 14th St Nw C-11 Washington DC 20009-6909 | |
| (202) 726-5106 | |
| (202) 882-0976 |
| Full Name | Water Brook Dental |
|---|---|
| Speciality | Dentist |
| Location | 2750 14th St Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Marlene Saint-phard Shaw (OWNER) |
| Authorized Official Contact | 2027265106 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Water Brook Dental 7826 Eastern Ave Nw Suite 301 Washington DC 20012-1324 Ph: (202) 726-5106 | Water Brook Dental 2750 14th St Nw C-11 Washington DC 20009-6909 Ph: (202) 726-5106 |
| NPI Number | 1275812729 |
|---|---|
| Provider Enumeration Date | 08/15/2011 |
| Last Update Date | 08/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275812729 | NPI | - | NPPES |
| 012049900 | Medicaid | MD | |
| 037396400 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DEN1000381 (District Of Columbia) | Primary |
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