Provider Demographics
NPI:1811198997
Name:DAVID A FIELDS D.D.S.P.A.
Entity Type:Organization
Organization Name:DAVID A FIELDS D.D.S.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-747-1330
Mailing Address - Street 1:6884 TRAVELERS REST CIR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7668
Mailing Address - Country:US
Mailing Address - Phone:410-747-1330
Mailing Address - Fax:410-747-6805
Practice Address - Street 1:511 JERMONE LANE
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-875-3344
Practice Address - Fax:410-875-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD51981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1134222516Medicare UPIN