Healthcare Provider Details

I. General information

NPI: 1285307231
Provider Name (Legal Business Name): DAVID ROSS ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 FALLS RD
LUTHERVILLE TIMONIUM MD
21093-4571
US

IV. Provider business mailing address

10801 FALLS RD
LUTHERVILLE TIMONIUM MD
21093-4571
US

V. Phone/Fax

Practice location:
  • Phone: 443-901-3100
  • Fax:
Mailing address:
  • Phone: 443-901-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DAVID ROBERT ROSS
Title or Position: ORTHODONTIST
Credential: DDS, MS
Phone: 443-901-3100