Provider Demographics
NPI:1578983896
Name:FAMILY DENTAL CARE CENTER
Entity Type:Organization
Organization Name:FAMILY DENTAL CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-839-6330
Mailing Address - Street 1:6188 OXON HILL RD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3113
Mailing Address - Country:US
Mailing Address - Phone:301-839-6330
Mailing Address - Fax:301-839-6753
Practice Address - Street 1:6188 OXON HILL ROAD
Practice Address - Street 2:SUITE 406
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745
Practice Address - Country:US
Practice Address - Phone:301-839-6330
Practice Address - Fax:301-839-6753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8120332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1003980368OtherGENERAL DENTIST