Provider Demographics
NPI:1033636634
Name:TOOTHMAN ORTHODONTICS, PA
Entity Type:Organization
Organization Name:TOOTHMAN ORTHODONTICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CATANIA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:301-791-1770
Mailing Address - Street 1:81 N EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6501
Mailing Address - Country:US
Mailing Address - Phone:301-791-1770
Mailing Address - Fax:
Practice Address - Street 1:81 N EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6501
Practice Address - Country:US
Practice Address - Phone:301-791-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14635261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1356496921OtherJEFFREY TOOTHMAN
1275670952OtherRONALD TOOTHMAN