MEDICARE: DR. DUANE L ARCHER DDS, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	13429	MD

General Provider Information

NPI Number	:	1518186493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUANE L ARCHER DDS, MPH

Provider Business Mailing Address
First Line	:	8850 COLUMBIA 100 PKWY
Second Line	:	SUITE 312
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2374
Country	:	US
Telephone Number	:	410-884-0262
Fax Number	:	410-884-0263

Provider Business Practice Location Address
First Line	:	8850 COLUMBIA 100 PKWY
Second Line	:	SUITE 312
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2374
Country	:	US
Telephone Number	:	410-884-0262
Fax Number	:	410-884-0263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/08/2007

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