Provider Demographics
NPI:1174346753
Name:AMIN AND STROUTH DDS PA
Entity type:Organization
Organization Name:AMIN AND STROUTH DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL HYGIENE DEPARTMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-863-7077
Mailing Address - Street 1:21875 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-1564
Mailing Address - Country:US
Mailing Address - Phone:301-863-7077
Mailing Address - Fax:
Practice Address - Street 1:22700 WASHINGTON STREET
Practice Address - Street 2:SUITE C
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650
Practice Address - Country:US
Practice Address - Phone:301-444-9337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMIN AND STROUTH DDS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental