Provider Demographics
NPI:1912047606
Name:SUGAR, MARTIN S (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:S
Last Name:SUGAR
Suffix:
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 1:3 CRYSTAL FIELD CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1564
Mailing Address - Country:US
Mailing Address - Phone:410-804-1217
Mailing Address - Fax:
Practice Address - Street 1:3 CRYSTAL FIELD CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1564
Practice Address - Country:US
Practice Address - Phone:410-804-1217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD157411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice