Provider Demographics
NPI:1073668794
Name:MARKOVITZ, STANLEY J (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:J
Last Name:MARKOVITZ
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 BEDFORD AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6604
Mailing Address - Country:US
Mailing Address - Phone:410-653-6379
Mailing Address - Fax:410-653-9430
Practice Address - Street 1:1314 BEDFORD AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6604
Practice Address - Country:US
Practice Address - Phone:410-653-6379
Practice Address - Fax:410-653-9430
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD93811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics