Organization
SUSAN E VICKERS DMD PA
Active
Organization
SUSAN E VICKERS DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN E VICKERS DMD MS (OWNER PRESIDENT)
(410) 749-0009
Entity
Organization
Contact information
Practice address
11029 RACETRACK RD, BERLIN, MD 21811
(410) 749-0009
(410) 749-0022
Mailing address
PO BOX 1730, BERLIN, MD 21811
(410) 749-0009
(410) 749-0022
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000039987
—
DE
Enumeration date
03/13/2007
Last updated
09/11/2025
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