Organization
TYSON BROSS DMD PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYSON BROSS DMD PHD (PRINCIPAL)
(443) 373-1634
Entity
Organization
Contact information
Practice address
129 LUBRANO DR STE 300, ANNAPOLIS, MD 21401-7568
(410) 224-0018
(410) 224-4214
Mailing address
101 EARECKSON LN, STEVENSVILLE, MD 21666-3037
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
14024
MD
Other
Enumeration date
10/11/2017
Last updated
10/11/2017
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