MEDICARE: ALLAN DWORKIN 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	1223P0221X	Pediatric Dentistry	4152	MD

General Provider Information

NPI Number	:	1669429874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLAN DWORKIN DDS

Provider Business Mailing Address
First Line	:	2 HAMILL RD
Second Line	:	SUITE 266 SOUTH
City	:	BALTIMORE
State	:	MD
Zip	:	21210-1806
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 HAMILL RD
Second Line	:	SUITE 266 SOUTH
City	:	BALTIMORE
State	:	MD
Zip	:	21210-1806
Country	:	US
Telephone Number	:	410-435-8400
Fax Number	:	410-435-6486

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/08/2007

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Directions to “ ALLAN DWORKIN DDS” Practice Location

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