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General NPI Number Information
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NPI Number | 1548350952
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Entity Type | Organization
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Legal Business Name | HERBERT BRICKEN DDS PA
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Dates
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Enumeration Date | 10/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2415 MUSGROVE ROAD SUITE 109
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City | SILVER SPRING
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State | MD
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Zip | 20904
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Country | US
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Telephone | 301-879-0280
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 MUSGROVE ROAD SUITE 109
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City | SILVER SPRING
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State | MD
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Zip | 20904
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Country | US
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Telephone | 301-879-0280
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HERBERT BRICKEN
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Credential | DDS
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Telephone | 301-879-0280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2592
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License Number State | MD
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