Champion Smiles of Maryland LLC

NPI #1396330049 in La Plata, Maryland

Provider Information

NPI Number: 1396330049
Entity Type: Organization
Organization Name: Champion Smiles of Maryland LLC
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Mar 4, 2021
Last Updated: Mar 4, 2021

Practice Location

Address: 113 LA GRANGE AVE
City: La Plata
State: Maryland
ZIP Code: 20646-9592
Phone: (301) 249-4123

Authorized Official

Name: AMBER GIBBS
Title: PRACTICE MANAGER
Phone: (301) 249-4123

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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