Provider Demographics
NPI:1518287507
Name:ALVAREZ, PEDRO MARIO III (DDS)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:MARIO
Last Name:ALVAREZ
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11325 SEVEN LOCKS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3269
Mailing Address - Country:US
Mailing Address - Phone:240-642-3161
Mailing Address - Fax:
Practice Address - Street 1:11325 SEVEN LOCKS RD STE 250
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3269
Practice Address - Country:US
Practice Address - Phone:240-642-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855652122300000X
NY056594122300000X
MD16523122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist