Healthcare Provider Details

I. General information

NPI: 1053610352
Provider Name (Legal Business Name): HARRY Y. CANTER, JR. D.D.S PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 C CYNWOOD DRIVE
EASTON MD
21601-3886
US

IV. Provider business mailing address

556 C CYNWOOD DRIVE
EASTON MD
21601-3886
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-1183
  • Fax:
Mailing address:
  • Phone: 410-822-1183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number07291
License Number StateMD

VIII. Authorized Official

Name: HARRY Y CANTER JR.
Title or Position: OWNER
Credential: D.D.S
Phone: 410-822-1183