Provider Demographics
NPI:1801404157
Name:RCT ENDODONTICS OF NORTH POTOMAC, LLC
Entity Type:Organization
Organization Name:RCT ENDODONTICS OF NORTH POTOMAC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:BAGGARLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-260-3221
Mailing Address - Street 1:16901 MELFORD BLVD STE 332
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4443
Mailing Address - Country:US
Mailing Address - Phone:240-260-3221
Mailing Address - Fax:240-243-2269
Practice Address - Street 1:11906 DARNESTOWN RD STE G
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2200
Practice Address - Country:US
Practice Address - Phone:301-947-3400
Practice Address - Fax:240-243-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty