Healthcare Provider Details

I. General information

NPI: 1386643856
Provider Name (Legal Business Name): DYNASPLINT SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 RITCHIE HIGHWAY SUITE W-21
SEVERNA PARK MD
21146-4152
US

IV. Provider business mailing address

770 RITCHIE HIGHWAY SUITE W-21
SEVERNA PARK MD
21146-4152
US

V. Phone/Fax

Practice location:
  • Phone: 800-638-6771
  • Fax: 800-380-3784
Mailing address:
  • Phone: 800-638-6771
  • Fax: 800-380-3784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1121034
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number1121034
License Number StateMD

VIII. Authorized Official

Name: GEORGE R. HEPBURN
Title or Position: PRESIDENT
Credential: P.T.
Phone: 800-638-6771