Provider Demographics
NPI:1053484345
Name:EHUDIN, DEBRA Z (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:Z
Last Name:EHUDIN
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 1:42 BELLCHASE CT
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1300
Mailing Address - Country:US
Mailing Address - Phone:410-484-2117
Mailing Address - Fax:410-484-2362
Practice Address - Street 1:1852 REISTERSTOWN RD
Practice Address - Street 2:SUITE#200
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1392
Practice Address - Country:US
Practice Address - Phone:410-484-2117
Practice Address - Fax:410-484-2362
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD99181223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics