Provider Demographics
NPI:1003352790
Name:HUNT VALLEY ORTHODONTICS, INC.
Entity Type:Organization
Organization Name:HUNT VALLEY ORTHODONTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:C
Authorized Official - Last Name:KOHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-771-8100
Mailing Address - Street 1:100 SPARKS VALLEY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9342
Mailing Address - Country:US
Mailing Address - Phone:410-771-8100
Mailing Address - Fax:410-771-8201
Practice Address - Street 1:100 SPARKS VALLEY RD
Practice Address - Street 2:SUITE C
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9342
Practice Address - Country:US
Practice Address - Phone:410-771-8100
Practice Address - Fax:410-771-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10522122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty