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General NPI Number Information
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NPI Number | 1861726119
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Entity Type | Individual
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Provider Name | MARK NALBANDIAN D.D.S
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Gender | Male
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 331 GAMBRILLS RD
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City | GAMBRILLS
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State | MD
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Zip | 21054-1141
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Country | US
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Telephone | 703-753-4486
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 16TH ST NW APT 508
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City | WASHINGTON
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State | DC
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Zip | 20009-6586
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Country | US
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Telephone | 917-583-3656
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Fax |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 14655
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License Number State | MD
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