Provider Demographics
NPI:1558476853
Name:KANTER, JOAN MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:MARIE
Last Name:KANTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5076 DORSEY HALL DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7711
Mailing Address - Country:US
Mailing Address - Phone:410-715-9555
Mailing Address - Fax:410-715-9557
Practice Address - Street 1:5076 DORSEY HALL DR
Practice Address - Street 2:SUITE 106
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7711
Practice Address - Country:US
Practice Address - Phone:410-715-9555
Practice Address - Fax:410-715-9557
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD131861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD157605860Medicaid