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General NPI Number Information
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NPI Number | 1346971058
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Entity Type | Individual
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Provider Name | JULIO ABRAHAN BERMUDEZ DMD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 8055 RITCHIE HWY STE 102
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City | PASADENA
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State | MD
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Zip | 21122-1074
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Country | US
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Telephone | 954-483-6999
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 S CONKLING ST APT 513
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City | BALTIMORE
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State | MD
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Zip | 21224-5349
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Country | US
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Telephone | 954-483-6999
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 17474
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License Number State | MD
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