1013071240 NPI number — RICHARD W. MUTHS, D.D.S. AND ASSOCIATES, P.C.

Table of content: MRS. MELANIE CONSUELO HARRIGAN LMSW (NPI 1518604537)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013071240 NPI number — RICHARD W. MUTHS, D.D.S. AND ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD W. MUTHS, D.D.S. AND ASSOCIATES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013071240
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9516 PHILADELPHIA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21237-4106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-391-9565
Provider Business Mailing Address Fax Number:
410-391-7458

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9516 PHILADELPHIA RD
Provider Second Line Business Practice Location Address:
KINGS COURT FAMILY DENTISTRY
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21237-4106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-391-9565
Provider Business Practice Location Address Fax Number:
410-391-7458
Provider Enumeration Date:
12/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MUTHS
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
WILLIAM
Authorized Official Title or Position:
OWNER, PRESIDENT
Authorized Official Telephone Number:
410-391-9565

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  6710 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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