Provider Demographics
NPI:1518263763
Name:DENTAPROSERVICES
Entity Type:Organization
Organization Name:DENTAPROSERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:SALEH
Authorized Official - Last Name:AMED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-729-0390
Mailing Address - Street 1:677 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1326
Mailing Address - Country:US
Mailing Address - Phone:410-729-0390
Mailing Address - Fax:410-729-0391
Practice Address - Street 1:677 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1326
Practice Address - Country:US
Practice Address - Phone:410-729-0390
Practice Address - Fax:410-729-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty