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General NPI Number Information
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NPI Number | 1598106056
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Entity Type | Organization
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Legal Business Name | TOOTHMAN ORTHODONTICS LLC
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 10 W COLLEGE TER
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City | FREDERICK
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State | MD
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Zip | 21701-4909
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Country | US
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Telephone | 301-662-3366
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Fax | 301-662-3362
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Provider Business Mailing Address
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Address Line | 10 W COLLEGE TER
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City | FREDERICK
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State | MD
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Zip | 21701-4909
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Country | US
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Telephone | 301-662-3366
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Fax | 301-662-3362
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHRISTINE HASLUP
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Credential |
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Telephone | 301-662-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 14635
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License Number State | MD
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