Organization
ANTIETAM ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL THOMAS THOMOPULOS DDS.,MDS (OWNER)
(301) 733-1552
Entity
Organization
Contact information
Practice address
322 E ANTIETAM ST, SUITE103, HAGERSTOWN, MD 21740-5794
(301) 733-1552
(301) 733-1553
Mailing address
322 E ANTIETAM ST, SUITE103, HAGERSTOWN, MD 21740-5794
(301) 733-1552
(301) 733-1553
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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