Champion Smiles Of Maryland Llc

LBN: Champion Smiles Of Maryland Llc
Champion Smiles Of Maryland Llc is an health care organization with primary practice located at 113 La Grange Ave , La Plata MD 20646-9592. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Champion Smiles Of Maryland Llc can be contacted via phone (301) 249-4123, or through Gibbs, Amber via phone (301) 249-4123.

Contact Information

Primary practice address
113 La Grange Ave La Plata MD 20646-9592
Phone: (301) 249-4123
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gibbs, Amber
Phone: (301) 249-4123

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X

Profile Details

NPI number 1396330049
LBN Legal business name Champion Smiles Of Maryland Llc
DBA Doing business as
Authorized official Gibbs, Amber
Entity Organization
Organization subpart 1 No
Enumeration date Mar 4th, 2021
Last updated Mar 4th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396330049 NPPES
Maryland MEDICAID 054215600

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