Organization
KENNETH TILLES, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH TILLES O.D. (PRESIDENT)
(410) 828-4132
Entity
Organization
Contact information
Practice address
825 DULANEY VALLEY RD, SUITE 264, TOWSON, MD 21204-1010
(410) 828-4133
(410) 828-4646
Mailing address
825 DULANEY VALLEY RD, SUITE 264, TOWSON, MD 21204-1010
(410) 828-4133
(410) 828-4646
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0641
MD
Other
Enumeration date
03/04/2012
Last updated
03/28/2012
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