Provider Demographics
NPI:1508386772
Name:DAVID A MUGFORD DMD PA
Entity Type:Organization
Organization Name:DAVID A MUGFORD DMD PA
Other - Org Name:THE MUGFORD CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUGFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PA
Authorized Official - Phone:410-721-7801
Mailing Address - Street 1:1660 VILLAGE GRN # 104
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2033
Mailing Address - Country:US
Mailing Address - Phone:410-721-7801
Mailing Address - Fax:410-721-7802
Practice Address - Street 1:1660 VILLAGE GRN # 104
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2033
Practice Address - Country:US
Practice Address - Phone:410-721-7801
Practice Address - Fax:410-721-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD116511223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty