Crown & Glory Dental, Llc

LBN: Crown & Glory Dental, Llc
Crown & Glory Dental, Llc is an health care organization with primary practice located at 11479 Berry Rd , Waldorf MD 20603-5957. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Crown & Glory Dental, Llc can be contacted via phone (202) 425-9618, or through Bush, Nakia S. via phone (240) 754-7425.

Contact Information

Primary practice address
11479 Berry Rd Waldorf MD 20603-5957
Phone: (202) 425-9618
Fax: (240) 754-7425
Website:
Map and Directions
Authorized official contact:
Name: Bush, Nakia S. Doctor of Dental Surgery (DDS)
Phone: (240) 754-7425

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1528656600
LBN Legal business name Crown & Glory Dental, Llc
DBA Doing business as
Authorized official Bush, Nakia S. Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2021
Last updated Jan 5th, 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 1528656600 NPPES
Maryland MEDICAID 039376200

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