Provider Demographics
NPI:1477343770
Name:TIGER FAMILY DENTAL CARE LLC
Entity type:Organization
Organization Name:TIGER FAMILY DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FORENTINO
Authorized Official - Middle Name:
Authorized Official - Last Name:PALACIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-676-1702
Mailing Address - Street 1:13417 ACCENT WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1407
Mailing Address - Country:US
Mailing Address - Phone:240-676-1702
Mailing Address - Fax:
Practice Address - Street 1:751 ROCKVILLE PIKE STE 3A
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1184
Practice Address - Country:US
Practice Address - Phone:240-676-1702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TIGER FAMILY DENTAL CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty