Healthcare Provider Details

I. General information

NPI: 1861785750
Provider Name (Legal Business Name): SYLVAN S MINTZ,DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 OLD GEORGETOWN RD SUITE 106
BETHESDA MD
20814-1911
US

IV. Provider business mailing address

10401 OLD GEORGETOWN RD SUITE 106
BETHESDA MD
20814-1911
US

V. Phone/Fax

Practice location:
  • Phone: 301-530-8570
  • Fax: 301-530-8572
Mailing address:
  • Phone: 301-530-8570
  • Fax: 301-530-8572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4351
License Number StateMD

VIII. Authorized Official

Name: DR. SYLVAN S MINTZ
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 301-530-8570