Provider Demographics
NPI:1669502266
Name:PACKMAN, HAROLD (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:
Last Name:PACKMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 BLACKFOOT DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2522
Mailing Address - Country:US
Mailing Address - Phone:410-721-2477
Mailing Address - Fax:
Practice Address - Street 1:7600 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3718
Practice Address - Country:US
Practice Address - Phone:410-761-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD51631223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics