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NPI Code Detail

MEDICARE: MOLZ CORP.

MEDICARE: MOLZ CORP.
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1669725453
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOLZ CORP.
Provider Business Mailing Address
First Line : 757 ANNAPOLIS ROAD
Second Line :
City : GAMBRILLS
State : MD
Zip : 21054-1308
Country : US
Telephone Number : 410-987-1418
Fax Number : 410-923-1145
Provider Business Practice Location Address
First Line : 747 ANNAPOLIS RD
Second Line :
City : GAMBRILLS
State : MD
Zip : 21054-1308
Country : US
Telephone Number : 410-987-1418
Fax Number : 410-923-1145
Authorized Official
Title or Position : OWNER/DOCTOR
Name : DR. STEPHEN CHARLES MOLZ
Credential : D.D.S.
Telephone Number : 410-987-1418
Provider Enumeration Date : 10/18/2012
Last Update Date : 10/18/2012

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