Provider Demographics
NPI:1922205699
Name:RUTHERFORD&RUTHERFORD D.D.S., P.A..
Entity Type:Organization
Organization Name:RUTHERFORD&RUTHERFORD D.D.S., P.A..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-676-4477
Mailing Address - Street 1:700 FALCONER RD
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-4422
Mailing Address - Country:US
Mailing Address - Phone:410-676-4477
Mailing Address - Fax:410-679-0842
Practice Address - Street 1:700 FALCONER RD
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-4422
Practice Address - Country:US
Practice Address - Phone:410-676-4477
Practice Address - Fax:410-679-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9190261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental