| Dhhs Dental Program | |
|
1335 Piccard Dr 1st Floor Dental Suite Rockville MD 20850-4359 | |
| (240) 777-1820 | |
| (240) 777-1080 |
| Full Name | Dhhs Dental Program |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1335 Piccard Dr, Rockville, Maryland |
| Authorized Official Name and Position | Timothy Firestine (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 2407772500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dhhs Dental Program 101 Monroe St Rockville MD 20850-2503 Ph: (240) 777-2500 | Dhhs Dental Program 1335 Piccard Dr 1st Floor Dental Suite Rockville MD 20850-4359 Ph: (240) 777-1820 |
| NPI Number | 1093094476 |
|---|---|
| Provider Enumeration Date | 08/16/2011 |
| Last Update Date | 01/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093094476 | NPI | - | NPPES |
| 420870600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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