Organization
BERNARD J DORMER DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNARD J DORMER DDS (DR DORMER EMPLOYER)
(410) 749-0248
Entity
Organization
Contact information
Practice address
1410 S SALISBURY BLVD, STE 3, SALISBURY, MD 21801-7127
(410) 749-0248
(410) 749-0292
Mailing address
1410 S SALISBURY BLVD, STE 3, SALISBURY, MD 21801-7127
(410) 749-0248
(410) 749-0292
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
MD05156
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141236
UNITED CONCORDIA
—
Enumeration date
07/08/2006
Last updated
08/22/2020
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