Healthcare Provider Details

I. General information

NPI: 1376775510
Provider Name (Legal Business Name): DR. DAVID M. VIETH 2, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2009
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2313 N POINT BLVD
DUNDALK MD
21222-1623
US

IV. Provider business mailing address

210 INTERSTATE NORTH PKWY SE STE 300
ATLANTA GA
30339-2233
US

V. Phone/Fax

Practice location:
  • Phone: 443-503-4903
  • Fax:
Mailing address:
  • Phone: 770-916-5028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID M VIETH
Title or Position: PRESIDENT
Credential: DDS
Phone: 770-916-5036