Provider Demographics
NPI:1881655629
Name:WINNICK, MARK B (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:B
Last Name:WINNICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:802 RUSSELL AVE
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3506
Mailing Address - Country:US
Mailing Address - Phone:301-926-8282
Mailing Address - Fax:301-330-6970
Practice Address - Street 1:802 RUSSELL AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3506
Practice Address - Country:US
Practice Address - Phone:301-926-8282
Practice Address - Fax:301-330-6970
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD49541223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics