Provider Demographics
NPI:1356470546
Name:GUNTER, CHARMAINE ANGELLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARMAINE
Middle Name:ANGELLA
Last Name:GUNTER
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 1:7100 BALTIMORE AVENUE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-3639
Mailing Address - Country:US
Mailing Address - Phone:301-864-3133
Mailing Address - Fax:301-864-3134
Practice Address - Street 1:7100 BALTIMORE AVENUE
Practice Address - Street 2:SUITE 309
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-3639
Practice Address - Country:US
Practice Address - Phone:301-864-3133
Practice Address - Fax:301-864-3134
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist