Pembrooke Square Ent Associates, LLC

NPI #1336321462 in Waldorf, Maryland

Provider Information

NPI Number: 1336321462
Entity Type: Organization
Organization Name: Pembrooke Square Ent Associates, LLC
Primary Specialty: Otolaryngology
Enumeration Date: Nov 30, 2007
Last Updated: Nov 30, 2007

Practice Location

Address: 11355 PEMBROOKE SQ STE 108
City: Waldorf
State: Maryland
ZIP Code: 20603-4805
Phone: (301) 645-4419

Authorized Official

Name: DR. GARY R MASON, M.D.
Title: OWNER
Phone: (301) 645-4419

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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