MEDICARE: CHRISTOPHER J DOERRER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6400	MD

General Provider Information

NPI Number	:	1598746422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER J DOERRER DDS

Provider Business Mailing Address
First Line	:	1211 ENTERPRISE RD
Second Line	:
City	:	MITCHELLVILLE
State	:	MD
Zip	:	20721-1909
Country	:	US
Telephone Number	:	301-249-3333
Fax Number	:	301-249-4214

Provider Business Practice Location Address
First Line	:	1211 ENTERPRISE RD
Second Line	:
City	:	MITCHELLVILLE
State	:	MD
Zip	:	20721-1909
Country	:	US
Telephone Number	:	301-249-3333
Fax Number	:	301-249-4214

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	07/08/2007

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