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General NPI Number Information
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NPI Number | 1518395524
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Entity Type | Organization
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Legal Business Name | SUMAN CHIBB DDS PA
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Dates
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Enumeration Date | 10/30/2013
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Last Update Date | 10/30/2013
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Provider Practice Location Address
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Address Line | 620 MAIN STREET
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City | REISTERSTOWN
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State | MD
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Zip | 21136
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Country | US
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Telephone | 410-526-5177
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Fax |
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Provider Business Mailing Address
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Address Line | 620 MAIN ST
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1910
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Country | US
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Telephone | 410-526-5177
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. SUMAN CHIBB
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Credential |
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Telephone | 410-526-5177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14159
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License Number State | MD
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