Healthcare Provider Details
I. General information
NPI: 1518668896
Provider Name (Legal Business Name): STERLING ENDODONTICS - BALTIMORE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2023
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1101 N POINT BLVD STE 126
BALTIMORE MD
21224-3417
US
IV. Provider business mailing address
808 LANDMARK DR STE 221
GLEN BURNIE MD
21061-4985
US
V. Phone/Fax
- Phone: 410-285-7177
- Fax: 410-284-6408
- Phone: 240-893-1775
- Fax: 410-705-0116
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JUHEON
SEUNG
Title or Position: OWNER
Credential: DDS
Phone: 410-482-5317