Healthcare Provider Details

I. General information

NPI: 1831702133
Provider Name (Legal Business Name): HIRSCHEL WOHL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021B EMMORTON RD STE 118
BEL AIR MD
21015-8958
US

IV. Provider business mailing address

903 KERSEY RD
SILVER SPRING MD
20902-3005
US

V. Phone/Fax

Practice location:
  • Phone: 410-569-8567
  • Fax:
Mailing address:
  • Phone: 443-690-2547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number16256
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: