21D2211179 CLIA NUMBER - SPECIAL CARE DENTISTRY LLC

Laboratory Demographics

CLIA Number: 21D2211179

Facility Name: SPECIAL CARE DENTISTRY LLC

Facility Address:
8700 CENTRAL AVE STE 100
LANDOVER, MD
ZIP 20785
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Facility Phone Number: 301 850-5015

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1285048918

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	21D2211179
LAB Type	Practitioner Other
Facility Name	SPECIAL CARE DENTISTRY LLC
Street	8700 CENTRAL AVE STE 100
City	LANDOVER
State	MD
ZIP	20785
Phone	301 850-5015
CertificateType	4
CertificateEffectiveDate	1/26/2023
CertificateExpirationDate	1/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024