Organization
W CHARLES MCLUCKIE DDS MS PC
Active
Other names
Allegany Orthodontics PC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ROBERT SNODGRASS DDS (ORTHODONTIST PRESIDENT)
(301) 722-5850
Entity
Organization
Contact information
Practice address
428 NATIONAL HWY, LAVALE, MD 21502-7129
(301) 722-5850
(301) 722-4960
Mailing address
428 NATIONAL HWY, LAVALE, MD 21502-7129
(301) 722-5850
(301) 722-4960
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13543
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006729
PHYSICIANS CARE
MD
01
—
1694475
UCCI
MD
Enumeration date
11/16/2005
Last updated
07/29/2008
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