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General NPI Number Information
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NPI Number | 1700317542
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Entity Type | Individual
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Provider Name | STEPHEN MARC-ANTHONY CROSS DDS
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Gender | Male
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Dates
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Enumeration Date | 03/23/2017
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 8913 WOODYARD RD UNIT B
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City | CLINTON
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State | MD
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Zip | 20735-4257
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Country | US
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Telephone | 202-372-5573
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Fax |
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Provider Business Mailing Address
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Address Line | 3012 BRETONS RIDGE WAY
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City | HANOVER
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State | MD
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Zip | 21076-2900
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Country | US
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Telephone |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 17008
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License Number State | MD
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