Provider Demographics
NPI:1154486280
Name:SELNICK, SANDRA E (DDS MS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:SELNICK
Suffix:
Gender:F
Credentials:DDS MS
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Other - First Name:
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Mailing Address - Street 1:5082 DORSEY HALL DR STE 202
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7754
Mailing Address - Country:US
Mailing Address - Phone:410-740-0002
Mailing Address - Fax:410-740-0930
Practice Address - Street 1:5082 DORSEY HALL DR STE 202
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7754
Practice Address - Country:US
Practice Address - Phone:410-740-0002
Practice Address - Fax:410-740-0930
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2022-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDMD104221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics