| Go West Medical Dental Services Llc | |
|
110 Baughmans Ln Suite 140 Frederick MD 21702-4059 | |
| (240) 215-1138 | |
| (240) 215-1140 |
| Full Name | Go West Medical Dental Services Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 110 Baughmans Ln, Frederick, Maryland |
| Authorized Official Name and Position | Julio J Menocal (OWNER) |
| Authorized Official Contact | 2402151138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Go West Medical Dental Services Llc Po Box 1149 Frederick MD 21702-0149 Ph: () - | Go West Medical Dental Services Llc 110 Baughmans Ln Suite 140 Frederick MD 21702-4059 Ph: (240) 215-1138 |
| NPI Number | 1174817811 |
|---|---|
| Provider Enumeration Date | 05/29/2011 |
| Last Update Date | 05/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174817811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | D31912 (Maryland) | Primary |
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