Provider Demographics
NPI:1790820918
Name:SHULMAN, MARK (DDS)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:SHULMAN
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E TIMONIUM RD STE 211
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3456
Mailing Address - Country:US
Mailing Address - Phone:410-832-5858
Mailing Address - Fax:410-821-5220
Practice Address - Street 1:20 E TIMONIUM RD STE 211
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3456
Practice Address - Country:US
Practice Address - Phone:410-832-5858
Practice Address - Fax:410-821-5220
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD59261223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice