Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 11641 | MD |
NPI | 1013971936 |
---|---|
Provider Name | Dr. Zenaida Mootso Cofie |
First Address | Severn, MD 21144-1485 |
Second Address | Towson, MD 21286 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 08/07/2007 |