Organization
SHERMAN H. DEVEAS III, DDS P.A.
Active
Other names
West Baltimore Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACEY J. WEITZEL (PRACTICE MANAGER)
(410) 566-2080
Entity
Organization
Contact information
Practice address
3322 FREDERICK AVE, BALTIMORE, MD 21229-3810
(410) 566-2080
(410) 566-6379
Mailing address
3322 FREDERICK AVE, BALTIMORE, MD 21229-3810
(410) 566-2080
(410) 566-6379
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
877136
UNITED CONCORDIA PROVIDER
MD
Enumeration date
01/30/2007
Last updated
08/22/2020
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