Premiere Ortho-Pedo Pllc
NPI #1003234360 in Washington, District of Columbia
Provider Information
- NPI Number
- 1003234360
- Entity Type
- Organization
- Organization Name
- Premiere Ortho-Pedo Pllc
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Apr 3, 2014
- Last Updated
- Nov 9, 2023
Practice Location
- Address
- 437 CEDAR ST NW
- City
- Washington
- State
- District of Columbia
- ZIP Code
- 20012-1931
- Phone
- (202) 725-7735
Authorized Official
- Name
- MARVIN BONFUAN NGWAFON
- Title
- PRESIDENT
- Phone
- (202) 725-7735
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
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