Shady Grove Modern Dental PC

NPI #1508802414 in Gaithersburg, Maryland

Provider Information

NPI Number: 1508802414
Entity Type: Organization
Organization Name: Shady Grove Modern Dental PC
Primary Specialty: Dentist
Enumeration Date: Jun 20, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 9051 SHADY GROVE COURT
City: Gaithersburg
State: Maryland
ZIP Code: 20877
Phone: (301) 330-4613

Authorized Official

Name: DUY TAM TRAN KIEM, DMD
Title: PRESIDENT
Phone: (301) 330-4613

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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