Provider Demographics
NPI:1770762627
Name:LOOKINGBILL, JON
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:
Last Name:LOOKINGBILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W TIMONIUM RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-7300
Mailing Address - Country:US
Mailing Address - Phone:410-252-1200
Mailing Address - Fax:410-252-9477
Practice Address - Street 1:110 W TIMONIUM RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-7300
Practice Address - Country:US
Practice Address - Phone:410-252-1200
Practice Address - Fax:410-252-9477
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD129951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice