Provider Demographics
NPI:1932395241
Name:STEWART, DANIES CHARLES (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANIES
Middle Name:CHARLES
Last Name:STEWART
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 1:9170 RTE 108
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1987
Mailing Address - Country:US
Mailing Address - Phone:410-730-6460
Mailing Address - Fax:410-730-1092
Practice Address - Street 1:9170 RTE 108
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1987
Practice Address - Country:US
Practice Address - Phone:410-730-6460
Practice Address - Fax:410-730-1092
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD104411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice