Provider Demographics
NPI:1629262381
Name:SCHLOSSBERG, RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:SCHLOSSBERG
Suffix:
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 1:8114 SANDPIPER CIRCLE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BALTO
Mailing Address - State:MD
Mailing Address - Zip Code:21236
Mailing Address - Country:US
Mailing Address - Phone:410-931-9400
Mailing Address - Fax:410-931-9510
Practice Address - Street 1:8114 SANDPIPER CIRCLE
Practice Address - Street 2:SUITE 210
Practice Address - City:BALTO
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-931-9400
Practice Address - Fax:410-931-9510
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD54771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice