Provider Demographics
NPI:1952670655
Name:MERRITT, BARBARA LEE (RDH)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LEE
Last Name:MERRITT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 CAPE SAINT JOHN RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7232
Mailing Address - Country:US
Mailing Address - Phone:410-224-8338
Mailing Address - Fax:
Practice Address - Street 1:479 JUMPERS HOLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-1600
Practice Address - Country:US
Practice Address - Phone:410-544-4444
Practice Address - Fax:410-544-7476
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1350124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist