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General NPI Number Information
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NPI Number | 1669502266
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Entity Type | Individual
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Provider Name | HAROLD PACKMAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7600 RITCHIE HWY
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City | GLEN BURNIE
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State | MD
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Zip | 21061-3718
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Country | US
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Telephone | 410-761-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 138 BLACKFOOT DR
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City | ARNOLD
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State | MD
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Zip | 21012-2522
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Country | US
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Telephone | 410-721-2477
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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 | 5163
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License Number State | MD
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