Organization
PDOM HAVRE DE GRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (INSURANCE DIRECTOR)
(727) 726-1611
Entity
Organization
Contact information
Practice address
2021 PULASKI HIGHWAY UNITS A AND B, HAVRE DE GRACE, MD 21078
(410) 939-9119
Mailing address
2021 PULASKI HIGHWAY UNITS A AND B, HAVRE DE GRACE, MD 21078
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/11/2012
Last updated
04/14/2015
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