Provider Demographics
NPI:1912163312
Name:ST. FRANCIS NEIGHBORHOOD CORP.
Entity Type:Organization
Organization Name:ST. FRANCIS NEIGHBORHOOD CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KING
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-347-2995
Mailing Address - Street 1:1023 N CHARLES ST
Mailing Address - Street 2:SUITE R3L
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5410
Mailing Address - Country:US
Mailing Address - Phone:410-347-2995
Mailing Address - Fax:410-659-1996
Practice Address - Street 1:1023 N CHARLES ST
Practice Address - Street 2:SUITE R3L
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5410
Practice Address - Country:US
Practice Address - Phone:410-347-2995
Practice Address - Fax:410-659-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD64531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty