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NPI Code Detail

MEDICARE: DR. STEPHEN CHARLES MOLZ D.D.S.,M.B.A.

MEDICARE: DR. STEPHEN CHARLES MOLZ D.D.S.,M.B.A.
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 Dentistry7898MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17898OTHERMDLICENSE NUMBER

General Provider Information

NPI Number : 1962609420
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN CHARLES MOLZ D.D.S.,M.B.A.
Provider Business Mailing 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
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2007
Last Update Date : 07/08/2007

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