Provider Demographics
NPI:1578853305
Name:BALTIMORE COLLEGE OF DENTAL SURGERY
Entity Type:Organization
Organization Name:BALTIMORE COLLEGE OF DENTAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PROFESSOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:RAMSAY
Authorized Official - Last Name:OSSO
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, MS
Authorized Official - Phone:410-706-7153
Mailing Address - Street 1:6287 BELMONT CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-8038
Mailing Address - Country:US
Mailing Address - Phone:301-829-2338
Mailing Address - Fax:
Practice Address - Street 1:650 W BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1510
Practice Address - Country:US
Practice Address - Phone:410-706-7153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4513124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty