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General NPI Number Information
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NPI Number | 1942692173
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Entity Type | Organization
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Legal Business Name | MCINNES PALMER ORTHODONTICS
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Dates
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Enumeration Date | 02/25/2015
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Last Update Date | 02/25/2015
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Provider Practice Location Address
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Address Line | 8322 BELLONA AVE 310
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City | TOWSON
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State | MD
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Zip | 21204-2065
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Country | US
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Telephone | 410-823-1900
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Fax | 410-823-5460
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Provider Business Mailing Address
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Address Line | 8322 BELLONA AVE 310
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City | TOWSON
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State | MD
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Zip | 21204-2065
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Country | US
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Telephone | 410-823-1900
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Fax | 410-823-5460
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. MEGHAN MCINNES PALMER
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Credential | D.D.S.
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Telephone | 410-823-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 14686
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License Number State | MD
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