Provider Demographics
NPI:1164612800
Name:MAYO, MAJOR BRADLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAJOR
Middle Name:BRADLEY
Last Name:MAYO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SPRING ST STE 302
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4012
Mailing Address - Country:US
Mailing Address - Phone:301-589-2545
Mailing Address - Fax:301-589-0012
Practice Address - Street 1:1015 SPRING ST STE 302
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4012
Practice Address - Country:US
Practice Address - Phone:301-589-2545
Practice Address - Fax:301-589-0012
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD-85111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice