Provider Demographics
NPI:1508315904
Name:SINGH, SMRITI (DMD)
Entity Type:Individual
Prefix:
First Name:SMRITI
Middle Name:
Last Name:SINGH
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 1:4510 EDMONDSON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-1506
Mailing Address - Country:US
Mailing Address - Phone:410-233-5777
Mailing Address - Fax:410-233-5794
Practice Address - Street 1:4510 EDMONDSON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-1506
Practice Address - Country:US
Practice Address - Phone:410-233-5777
Practice Address - Fax:410-233-5794
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16178122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist