Provider Demographics
NPI:1538292420
Name:MARY C. TRAHAR, DDS, PA
Entity Type:Organization
Organization Name:MARY C. TRAHAR, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:TRAHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-280-2484
Mailing Address - Street 1:716 GIDDINGS AVE
Mailing Address - Street 2:SUITE 31
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1408
Mailing Address - Country:US
Mailing Address - Phone:410-280-2484
Mailing Address - Fax:410-280-0416
Practice Address - Street 1:716 GIDDINGS AVE
Practice Address - Street 2:SUITE 31
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1408
Practice Address - Country:US
Practice Address - Phone:410-280-2484
Practice Address - Fax:410-280-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty