Provider Demographics
NPI:1548585946
Name:DRS. ROH AND PARK, LLC
Entity Type:Organization
Organization Name:DRS. ROH AND PARK, LLC
Other - Org Name:LANHAM DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOONCHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-577-4377
Mailing Address - Street 1:9470 ANNAPOLIS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4048
Mailing Address - Country:US
Mailing Address - Phone:301-577-4377
Mailing Address - Fax:301-577-0870
Practice Address - Street 1:9470 ANNAPOLIS RD STE 101
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4048
Practice Address - Country:US
Practice Address - Phone:301-577-4377
Practice Address - Fax:301-577-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty