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General NPI Number Information
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NPI Number | 1245129816
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Entity Type | Individual
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Provider Name | CHRISTOPHER DOMINGO CRUZ DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 650 W BALTIMORE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1510
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Country | US
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Telephone | 315-399-0313
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Fax |
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Provider Business Mailing Address
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Address Line | 2 HOPKINS PLZ UNIT 2118
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City | BALTIMORE
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State | MD
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Zip | 21201-2948
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Country | US
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Telephone | 315-399-0313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 18807
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License Number State | MD
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