Deitrick, David Rush
Deitrick, David Rush is an individual health care provider with primary practice located at 815 Ritchie Hwy Suite 202, Severna Park MD 21146. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Deitrick, David Rush can be contacted via phone (410) 647-3883.Contact Information
Primary practice address
815 Ritchie Hwy Suite 202
Severna Park MD 21146
Phone: (410) 647-3883
Fax: (410) 647-0504
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 9419 | Maryland |
Profile Details
| NPI number | 1013093343 |
|---|---|
| LBN Legal business name | Deitrick, David Rush |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013093343 | NPPES |
| Other | 2228 | BLUE CROSS BLUE SHIELD | |
| Other | 180400 | BLUE CROSS BLUE SHIELD |
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