Healthcare Provider Details

I. General information

NPI: 1033746185
Provider Name (Legal Business Name): CYNTHIA ANN FINFROCK RDH, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W BALTIMORE ST RM 2202
BALTIMORE MD
21201-1510
US

IV. Provider business mailing address

650 W BALTIMORE ST RM 2202
BALTIMORE MD
21201-1510
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-4837
  • Fax:
Mailing address:
  • Phone: 410-706-4837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number3167
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: