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Organization
SPECTRUM DENTAL SERVICES P A
Active
Organization
SPECTRUM DENTAL SERVICES P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA R TURNER JOHNSON (BUSINESS MANAGER)
(410) 541-4432
Entity
Organization
Contact information
Practice address
200 EAST 33RD STREET, SUITE 284, BALTIMORE, MD 21218
(410) 235-0062
Mailing address
200 E 33RD STREET, SUITE 284, BALTIMORE, MD 21218
(410) 235-0062
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
7695
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004418
DORAL DENTAL
MD
01
—
000952871
UNITED CONCORDIA
MD
01
—
2009
CAREFIRST BLUECROSS
MD
05
—
261864800
—
MD
Enumeration date
05/11/2007
Last updated
11/10/2021
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