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General NPI Number Information
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NPI Number | 1669859435
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Entity Type | Organization
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Legal Business Name | SAMUEL WEALCATCH, D.D.S., P.A.
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 1700 REISTERSTOWN RD 106-107
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City | BALTIMORE
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State | MD
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Zip | 21208-1416
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Country | US
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Telephone | 410-602-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 REISTERSTOWN RD 106-107
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City | BALTIMORE
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State | MD
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Zip | 21208-1416
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Country | US
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Telephone | 410-602-1800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. SAMUEL A WEALCATCH
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Credential |
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Telephone | 410-602-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 10450
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License Number State | MD
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