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General NPI Number Information
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NPI Number | 1457469116
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Entity Type | Individual
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Provider Name | KENNETH ROGERS CLORE DDS
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9801 GEORGIA AVE SUITE 225
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City | SILVER SPRING
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State | MD
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Zip | 20902-5276
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Country | US
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Telephone | 301-681-9111
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Fax | 301-681-9112
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Provider Business Mailing Address
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Address Line | 261 BRINKWOOD RD
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City | BROOKEVILLE
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State | MD
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Zip | 20833-2305
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Country | US
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Telephone | 301-774-4371
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Fax | 301-774-3162
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | MD 5352
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License Number State | MD
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