Ortho Suite LLC
Dentist, Orthodontics and Dentofacial Orthopedics in Bethesda, MD. Organization (NPI-2).
NPI number1013596964
StatusActive
Last updated in NPPESApr 7, 2021
Details
- NPI
- 1013596964
- Entity type
- Organization (NPI-2)
- Legal business name
- Ortho Suite LLC
- Organization subpart
- No
- Enumeration date
- Apr 7, 2021
- Certification date
- Apr 7, 2021
- Last updated
- Apr 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – | Yes |
Practice location
5642 Shields DrBethesda, MD 20817-3573
Phone 301-363-9026
Mailing address
5642 Shields DrBethesda, MD 20817-3573
Phone 301-363-9026
Authorized official
Derek Blank
President
9493025146
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