Healthcare Provider Details

I. General information

NPI: 1992024251
Provider Name (Legal Business Name): ABIGAIL MINA STRINGER WILLITSFORD D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2010
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9917 CARRIGAN DR
ELLICOTT CITY MD
21042-3617
US

IV. Provider business mailing address

9917 CARRIGAN DR
ELLICOTT CITY MD
21042-3617
US

V. Phone/Fax

Practice location:
  • Phone: 814-404-6601
  • Fax:
Mailing address:
  • Phone: 814-404-6601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN19266
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number15086
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: