Individual
DR. PHILLIP BARRY SUROSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4821 BUTLER ROAD, 2B, GLYNDON, MD 21071
(410) 833-6200
(410) 833-6365
Mailing address
4821 BUTLER ROAD, 2B, GLYNDON, MD 21071
(410) 833-6200
(410) 833-6365
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7474
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
521400959
TAX ID
MD
Enumeration date
03/09/2007
Last updated
10/01/2012
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