Individual
DWAYNE ERIC EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1501 DIVISION ST, BALTIMORE, MD 21217-3121
(410) 383-8300
(410) 383-3160
Mailing address
1501 DIVISION ST, BALTIMORE, MD 21217-3121
(410) 383-8300
(410) 383-3160
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10227
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10227
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348734200
—
MD
Enumeration date
12/08/2006
Last updated
04/19/2023
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