Healthcare Provider Details

I. General information

NPI: 1962561662
Provider Name (Legal Business Name): HARRY Y CANTER JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 04/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 CYNWOOD DR SUITE C
EASTON MD
21601-3805
US

IV. Provider business mailing address

556 CYNWOOD DR SUITE C
EASTON MD
21601-3805
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-1183
  • Fax: 410-820-7938
Mailing address:
  • Phone: 410-822-1183
  • Fax: 410-820-7938

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:
Title or Position:
Credential:
Phone: