Provider Demographics
NPI:1508930132
Name:DOBBIN DENTAL SUITE
Entity Type:Organization
Organization Name:DOBBIN DENTAL SUITE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-997-9366
Mailing Address - Street 1:6395 DOBBIN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045
Mailing Address - Country:US
Mailing Address - Phone:410-997-9366
Mailing Address - Fax:410-715-1318
Practice Address - Street 1:6395 DOBBIN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:410-997-9366
Practice Address - Fax:410-715-1318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD56291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty