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AUDUBON DENTAL CENTER OF CLINTON NPI 1497393219


NPI Information

NPI: 1497393219
Provider Name: AUDUBON DENTAL CENTER OF CLINTON
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
8918 WOODYARD RD
CLINTON, MD
ZIP 20735
Phone: (301) 856-1122
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AUDUBON DENTAL CENTER OF CLINTON is a general practice dentist in Clinton, MD. The provider is 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. AUDUBON DENTAL CENTER OF CLINTON NPI is 1497393219. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8918 WOODYARD RD
CLINTON, MD
ZIP 20735
Phone: (301) 856-1122
Fax: (301) 856-1759

The provider's authorized official is Tamatha C. Pantano .
The authorized official title is Owner and has the following contact phone number (301) 856-1122.

The enumeration date for this NPI number is 12/11/2019 and was last updated on 12/11/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1049843200MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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