| Supreme Dental Llc | |
|
401 E Jefferson St Ste 104 Rockville MD 20850-2617 | |
| (215) 350-8088 | |
| Not Available |
| Full Name | Supreme Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 401 E Jefferson St Ste 104, Rockville, Maryland |
| Authorized Official Name and Position | James Chiu (DENTIST) |
| Authorized Official Contact | 2153508088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supreme Dental Llc 401 E Jefferson St Ste 104 Rockville MD 20850-2617 Ph: (215) 350-8088 | Supreme Dental Llc 401 E Jefferson St Ste 104 Rockville MD 20850-2617 Ph: (215) 350-8088 |
| NPI Number | 1265241608 |
|---|---|
| Provider Enumeration Date | 12/31/2024 |
| Last Update Date | 12/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265241608 | NPI | - | NPPES |
| W15125180 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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