Provider Demographics
NPI:1619430949
Name:NORTH BETHESDA DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:NORTH BETHESDA DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:DORING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-881-7646
Mailing Address - Street 1:11400 ROCKVILLE PIKE STE 509
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3024
Mailing Address - Country:US
Mailing Address - Phone:301-881-7646
Mailing Address - Fax:301-881-7688
Practice Address - Street 1:11400 ROCKVILLE PIKE STE 509
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3024
Practice Address - Country:US
Practice Address - Phone:301-881-7646
Practice Address - Fax:301-881-7688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty