Individual
JOHN RANDOLPH IDDINGS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS0
Contact information
Practice address
VAMC 10 NORTH GREENE ST, DENTAL SERVICE, BALTIMORE, MD 21201-1524
(410) 605-7057
(410) 605-7819
Mailing address
4310 CRAB ORCHARD RD, GLEN ARM, MD 21057-9752
(410) 605-7057
(410) 605-7819
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
4171
MD
Other
Enumeration date
05/15/2006
Last updated
07/08/2007
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