1740313618 NPI number — DR. MARY CATHERINE TRAHAR-THOMAS DDS

Table of content: DR. MARY CATHERINE TRAHAR-THOMAS DDS (NPI 1740313618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740313618 NPI number — DR. MARY CATHERINE TRAHAR-THOMAS DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRAHAR-THOMAS
Provider First Name:
MARY
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1740313618
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
716 GIDDINGS AVE
Provider Second Line Business Mailing Address:
SUITE 31
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-1408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-280-2484
Provider Business Mailing Address Fax Number:
410-280-0416

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 SALLITT DR STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STEVENSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21666-2285
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-280-2484
Provider Business Practice Location Address Fax Number:
410-280-0416
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  12153 , 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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