Individual
DR. RICHARD MARK IMBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4809 LEEDS AVE, BALTIMORE, MD 21227
(410) 242-1112
(410) 418-9579
Mailing address
4809 LEEDS AVE, BALTIMORE, MD 21227
(410) 242-1112
(410) 418-9579
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
06979
MD
Other
Enumeration date
12/04/2008
Last updated
12/04/2008
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