Provider Demographics
NPI:1316205651
Name:TODD, MEREDITH BARR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:BARR
Last Name:TODD
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 1:402 MUSE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-1823
Mailing Address - Country:US
Mailing Address - Phone:410-228-5445
Mailing Address - Fax:
Practice Address - Street 1:402 MUSE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1823
Practice Address - Country:US
Practice Address - Phone:410-228-5445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15249122300000X, 122300000X
PADS039010122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist