Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 6427 | MD |
NPI | 1528585247 |
---|---|
Provider Name | Dr. Michael Mendelson |
First Address | Bethesda, MD 20814-4043 |
Second Address | Landover, MD 20785-2223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2017 |
Last Update Date | 23/08/2017 |