Provider Demographics
NPI:1043809650
Name:QODS ORTHO LLC
Entity Type:Organization
Organization Name:QODS ORTHO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-527-2725
Mailing Address - Street 1:849 QUINCE ORCHARD BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1604
Mailing Address - Country:US
Mailing Address - Phone:301-527-2725
Mailing Address - Fax:301-527-2724
Practice Address - Street 1:849 QUINCE ORCHARD BLVD STE D
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1604
Practice Address - Country:US
Practice Address - Phone:301-527-2725
Practice Address - Fax:301-527-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty