Provider Demographics
NPI:1164688313
Name:SYEDA, FATIMA (DMD)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:
Last Name:SYEDA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029
Mailing Address - Country:US
Mailing Address - Phone:443-676-0959
Mailing Address - Fax:
Practice Address - Street 1:2507 N POINT RD
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-1605
Practice Address - Country:US
Practice Address - Phone:410-284-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14104122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist