Provider Demographics
NPI:1740143189
Name:SILVERSPOON DENTAL AND ASSOCIATES
Entity type:Organization
Organization Name:SILVERSPOON DENTAL AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TYRUS
Authorized Official - Middle Name:G
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-266-1888
Mailing Address - Street 1:12300 KEMMERTON LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2721
Mailing Address - Country:US
Mailing Address - Phone:301-262-1888
Mailing Address - Fax:301-262-1999
Practice Address - Street 1:12300 KEMMERTON LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-2721
Practice Address - Country:US
Practice Address - Phone:301-262-1888
Practice Address - Fax:301-262-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty