Provider Demographics
NPI:1316156771
Name:BOLUS-ALIGNAY, AGNES F (DDS)
Entity type:Individual
Prefix:DR
First Name:AGNES
Middle Name:F
Last Name:BOLUS-ALIGNAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 PERSHING DR SUITE003
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4012
Mailing Address - Country:US
Mailing Address - Phone:301-608-9363
Mailing Address - Fax:301-608-9390
Practice Address - Street 1:804 PERSHING DR STE 3
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4436
Practice Address - Country:US
Practice Address - Phone:301-608-9363
Practice Address - Fax:301-608-9390
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1811091150OtherNPI