Individual
DR. BRENT MILLER KOUDELKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6900 GEORGIA AVE NW, BUILDING 2 ROOM 1D, WASHINGTON, DC 20307-5400
(202) 782-6815
(202) 782-6987
Mailing address
6900 GEORGIA AVE NW, WASHINGTON, DC 20307-5400
(202) 782-0988
(202) 782-9195
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30013909
OH
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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