| Smile Street Dental | |
|
6618a Security Blvd Woodlawn MD 21207-4010 | |
| (410) 575-1833 | |
| (410) 803-5297 |
| Full Name | Smile Street Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6618a Security Blvd, Woodlawn, Maryland |
| Authorized Official Name and Position | Amber T Royal (CEO) |
| Authorized Official Contact | 2025696708 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Street Dental 6618a Security Blvd Woodlawn MD 21207-4010 Ph: () - | Smile Street Dental 6618a Security Blvd Woodlawn MD 21207-4010 Ph: (410) 575-1833 |
| NPI Number | 1629609888 |
|---|---|
| Provider Enumeration Date | 01/27/2020 |
| Last Update Date | 02/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629609888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |