Crown & Glory Dental, Llc | |
11479 Berry Rd Waldorf MD 20603-5957 | |
(202) 425-9618 | |
(240) 754-7425 |
Full Name | Crown & Glory Dental, Llc |
---|---|
Speciality | Dentist - General Practice |
Location | 11479 Berry Rd, Waldorf, Maryland |
Authorized Official Name and Position | Nakia S. Bush (DENTIST/OWNER) |
Authorized Official Contact | 2407547425 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Crown & Glory Dental, Llc 11479 Berry Rd Waldorf MD 20603-5957 Ph: (202) 425-9618 | Crown & Glory Dental, Llc 11479 Berry Rd Waldorf MD 20603-5957 Ph: (202) 425-9618 |
NPI Number | 1528656600 |
---|---|
Provider Enumeration Date | 01/05/2021 |
Last Update Date | 01/05/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528656600 | NPI | - | NPPES |
039376200 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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