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Individual

DR. RAYMOND J MANSFIELD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
13239 EXECUTIVE PARK TER, GERMANTOWN, MD 20874-2648
(301) 540-5195
Mailing address
13239 EXECUTIVE PARK TER, GERMANTOWN, MD 20874-2648

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6165
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
075154
TRICARE
MD
Enumeration date
05/31/2005
Last updated
07/08/2007
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