Healthcare Provider Details

I. General information

NPI: 1497720841
Provider Name (Legal Business Name): GEORGE ALAN HURWITZ D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10782 HICKORY RIDGE RD
COLUMBIA MD
21044-3646
US

IV. Provider business mailing address

10782 HICKORY RIDGE RD
COLUMBIA MD
21044-3646
US

V. Phone/Fax

Practice location:
  • Phone: 410-730-6001
  • Fax:
Mailing address:
  • Phone: 410-730-6001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number4477
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: