Provider Demographics
NPI:1679835235
Name:SZYMANSKI, THEODORE VINCENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:VINCENT
Last Name:SZYMANSKI
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 1:285 PUMA DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-7850
Mailing Address - Country:US
Mailing Address - Phone:410-374-5200
Mailing Address - Fax:410-374-0062
Practice Address - Street 1:2113 HANOVER PIKE
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-1319
Practice Address - Country:US
Practice Address - Phone:410-374-5200
Practice Address - Fax:410-374-0062
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7285122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist