Provider Demographics
NPI:1720272453
Name:NUGER & SIRCUS DDS, PA
Entity Type:Organization
Organization Name:NUGER & SIRCUS DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIRCUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-766-4650
Mailing Address - Street 1:7836 OAKWOOD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4244
Mailing Address - Country:US
Mailing Address - Phone:410-766-4650
Mailing Address - Fax:
Practice Address - Street 1:7836 OAKWOOD RD
Practice Address - Street 2:SUITE B
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4244
Practice Address - Country:US
Practice Address - Phone:410-766-4650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty