Provider Demographics
NPI:1104826437
Name:BEAN, MARY F (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:BEAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1212 YORK RD
Mailing Address - Street 2:SUITE A 301
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6240
Mailing Address - Country:US
Mailing Address - Phone:410-828-7154
Mailing Address - Fax:410-821-7154
Practice Address - Street 1:1212 YORK RD
Practice Address - Street 2:SUITE A 301
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6240
Practice Address - Country:US
Practice Address - Phone:410-828-7154
Practice Address - Fax:410-821-7154
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD69321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice