| Organization Name: | 3D ORAL & MAXILLOFACIAL IMAGING CENTER, LLC |
| NPI Number: | 1013303403 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDY H. OH (OWNER) |
| Mailing Address: | 11125 Rockville Pike Ste 211 North Bethesda |
| State: | MD US |
| Postal Code: | 208523142 |
| Phone Number: | 2402210797 |
| Fax Number: | 2405605358 |
| NPI Enumeration Date: | 04/13/2015 |
| NPI Last Update Date: | 04/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 14334 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |