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General NPI Number Information
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NPI Number | 1124081872
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Entity Type | Organization
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Legal Business Name | ULERY DENTAL AND ORTHODONTICS
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 1286 MARYLAND RT 3 S
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City | CROFTON
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State | MD
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Zip | 21114-1340
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Country | US
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Telephone | 410-721-8200
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Fax | 410-721-7629
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Provider Business Mailing Address
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Address Line | 926 GREAT POND DR
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7244
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Country | US
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Telephone | 407-772-5124
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Fax | 407-788-3572
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | TERRI GARDINER
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Credential |
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Telephone | 407-772-5124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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