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General NPI Number Information
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NPI Number | 1063810562
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Entity Type | Individual
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Provider Name | OMUA ANGOLE DDS
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Gender | Female
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 1118 COLUMBIA RD NW
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City | WASHINGTON
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State | DC
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Zip | 20009-5306
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Country | US
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Telephone | 352-293-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 GREENWAY CENTER DR STE 260
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City | GREENBELT
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State | MD
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Zip | 20770-3548
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Country | US
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Telephone | 301-321-9966
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Fax | 240-241-4293
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16009
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License Number State | MD
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