Individual
DR. SUSANNE SCHOPPERT WALLENGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2324 WEST JOPPA RD, SUITE 430, LUTHERVILLE, MD 21093
(410) 321-0200
(410) 825-1159
Mailing address
2324 WEST JOPPA RD, SUITE 430, LUTHERVILLE, MD 21093
(410) 321-0200
(410) 825-1159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12747
MD
122300000X
Dentist
3351
NH
1223P0221X
Pediatric Dentistry
Primary
12747
MD
1223P0221X
Pediatric Dentistry
3351
NH
1223P0221X
Pediatric Dentistry
DS039549
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30304152
—
NH
Enumeration date
01/01/2007
Last updated
07/25/2013
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