| Aegis Dental Group Llc (dba Smiles4all) | |
|
12092 Ell Ln Waldorf MD 20602-3522 | |
| (301) 645-7777 | |
| Not Available |
| Full Name | Aegis Dental Group Llc (dba Smiles4all) |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12092 Ell Ln, Waldorf, Maryland |
| Authorized Official Name and Position | Ricardo Anthony Hector (OWNER/ DENTIST) |
| Authorized Official Contact | 3013104851 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aegis Dental Group Llc (dba Smiles4all) 12092 Ell Ln Waldorf MD 20602-3522 Ph: (301) 645-7777 | Aegis Dental Group Llc (dba Smiles4all) 12092 Ell Ln Waldorf MD 20602-3522 Ph: (301) 645-7777 |
| NPI Number | 1750948782 |
|---|---|
| Provider Enumeration Date | 05/24/2019 |
| Last Update Date | 05/24/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750948782 | NPI | - | NPPES |
| 13764 | Other | MD | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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