Provider Demographics
NPI:1689844409
Name:D AND S DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:D AND S DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DOUGHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-657-3220
Mailing Address - Street 1:4833 BETHESDA AVENUE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-5244
Mailing Address - Country:US
Mailing Address - Phone:301-657-3220
Mailing Address - Fax:301-657-1669
Practice Address - Street 1:4833 BETHESDA AVENUE
Practice Address - Street 2:SUITE 302
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5244
Practice Address - Country:US
Practice Address - Phone:301-657-3220
Practice Address - Fax:301-657-1669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty