Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 7855 | MD |
NPI | 1134175342 |
---|---|
Provider Name | Dr. Robert F. Prior |
First Address | California, MD 20619 |
Second Address | Lexington Park, MD 20653-3347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 08/07/2007 |