Provider Demographics
NPI:1013071240
Name:RICHARD W. MUTHS, D.D.S. AND ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:RICHARD W. MUTHS, D.D.S. AND ASSOCIATES, P.C.
Other - Org Name:KINGS COURT FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MUTHS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-391-9565
Mailing Address - Street 1:9516 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4106
Mailing Address - Country:US
Mailing Address - Phone:410-391-9565
Mailing Address - Fax:410-391-7458
Practice Address - Street 1:9516 PHILADELPHIA RD
Practice Address - Street 2:KINGS COURT FAMILY DENTISTRY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4106
Practice Address - Country:US
Practice Address - Phone:410-391-9565
Practice Address - Fax:410-391-7458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD67101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty