Provider Demographics
NPI:1679751416
Name:SCHLOBOHM, CORD HARTWIG (DMD)
Entity Type:Individual
Prefix:
First Name:CORD
Middle Name:HARTWIG
Last Name:SCHLOBOHM
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 1:4830 CORDELL AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3011
Mailing Address - Country:US
Mailing Address - Phone:301-656-8788
Mailing Address - Fax:301-656-4207
Practice Address - Street 1:4830 CORDELL AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3011
Practice Address - Country:US
Practice Address - Phone:301-656-8788
Practice Address - Fax:301-656-4207
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10398122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist