MEDICARE: STANLEY DORROW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4555	MD
2	332BC3200X	Customized Equipment (DME)		MD

General Provider Information

NPI Number	:	1245319417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANLEY DORROW

Provider Business Mailing Address
First Line	:	4000 OLD COURT RD STE 302
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-6418
Country	:	US
Telephone Number	:	410-654-0052
Fax Number	:	301-530-3293

Provider Business Practice Location Address
First Line	:	9010 OLD GEORGETOWN RD
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-1514
Country	:	US
Telephone Number	:	301-564-1542
Fax Number	:	301-530-3293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	06/16/2021

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Directions to “ STANLEY DORROW ” Practice Location

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