Provider Demographics
NPI:1013038983
Name:MAKOWSKE, RAYMOND T
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:T
Last Name:MAKOWSKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 CIVIC AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5230
Mailing Address - Country:US
Mailing Address - Phone:410-742-3000
Mailing Address - Fax:410-742-3653
Practice Address - Street 1:314 CIVIC AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5230
Practice Address - Country:US
Practice Address - Phone:410-742-3000
Practice Address - Fax:410-742-3653
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD58551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice