Provider Demographics
NPI:1003042045
Name:BALTIMORE COUNTY DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:BALTIMORE COUNTY DEPARTMENT OF HEALTH
Other - Org Name:DENTAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HIPAA COMPLIANCE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-887-2702
Mailing Address - Street 1:6401 YORK RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2152
Mailing Address - Country:US
Mailing Address - Phone:410-887-3740
Mailing Address - Fax:410-377-9646
Practice Address - Street 1:9150 FRANKLIN SQUARE DR FL 3
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3903
Practice Address - Country:US
Practice Address - Phone:410-887-2780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare