Provider Demographics
NPI:1720281199
Name:BURROWS, FREDERICK W JR (DDS)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:W
Last Name:BURROWS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 FREDERICK CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-5164
Mailing Address - Country:US
Mailing Address - Phone:301-662-2160
Mailing Address - Fax:301-662-7449
Practice Address - Street 1:5960 FREDERICK CROSSING LN
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-5164
Practice Address - Country:US
Practice Address - Phone:301-662-2160
Practice Address - Fax:301-662-7449
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD51841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice