| Organization Name: | TLC MODERN DENTISTRY |
| NPI Number: | 1558790154 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROSANN RODRIGUEZ (OFFICE MANAGER) |
| Mailing Address: | 18220 Contour Rd Montgomery Village |
| State: | MD US |
| Postal Code: | 208772623 |
| Phone Number: | 3012080002 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2013 |
| NPI Last Update Date: | 11/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 15202 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |