Provider Demographics
NPI:1073761607
Name:CALDWELL, LENORA EILEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LENORA
Middle Name:EILEEN
Last Name:CALDWELL
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 1:1714 PARK AVE
Mailing Address - Street 2:209
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-4334
Mailing Address - Country:US
Mailing Address - Phone:410-206-6434
Mailing Address - Fax:443-869-5724
Practice Address - Street 1:1000 E EAGER ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5533
Practice Address - Country:US
Practice Address - Phone:410-541-4432
Practice Address - Fax:410-522-9808
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13193122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist