Provider Demographics
NPI:1376757005
Name:BEN MANESH DDS III PC
Entity Type:Organization
Organization Name:BEN MANESH DDS III PC
Other - Org Name:CONGRESSIONAL DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-770-5400
Mailing Address - Street 1:1750 ROCKVILLE PIKE
Mailing Address - Street 2:10
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1658
Mailing Address - Country:US
Mailing Address - Phone:301-770-5400
Mailing Address - Fax:301-770-6642
Practice Address - Street 1:1750 ROCKVILLE PIKE
Practice Address - Street 2:10
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1658
Practice Address - Country:US
Practice Address - Phone:301-770-5400
Practice Address - Fax:301-770-6642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty