Provider Demographics
NPI:1770961120
Name:DUGHLY, REEM (DDS)
Entity type:Individual
Prefix:DR
First Name:REEM
Middle Name:
Last Name:DUGHLY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3879 WOODVILLE LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4837
Mailing Address - Country:US
Mailing Address - Phone:443-848-8037
Mailing Address - Fax:
Practice Address - Street 1:2288 BLUE WATER BLVD STE 420
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-3312
Practice Address - Country:US
Practice Address - Phone:410-672-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16068122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist