| Organization Name: | SPECIAL CARE DENTISTRY AT LANDOVER |
| NPI Number: | 1285048918 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NEKIA A STALEY-NEITHER (OWNER) |
| Mailing Address: | 8700 Central Ave Suite 100 Landover |
| State: | MD US |
| Postal Code: | 207854831 |
| Phone Number: | 3017353006 |
| Fax Number: | 3017353062 |
| NPI Enumeration Date: | 06/20/2014 |
| NPI Last Update Date: | 06/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 13458 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |