Healthcare Provider Details

I. General information

NPI: 1356413090
Provider Name (Legal Business Name): ROBERT D ISAACS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8406 HARFORD RD
BALTIMORE MD
21234-4638
US

IV. Provider business mailing address

8406 HARFORD RD
BALTIMORE MD
21234-4638
US

V. Phone/Fax

Practice location:
  • Phone: 410-466-4319
  • Fax:
Mailing address:
  • Phone: 410-466-4319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number08606
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: