Everett, Dwayne Eric

Everett, Dwayne Eric is an individual health care provider with primary practice located at 1501 Division St , Baltimore MD 21217-3121. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Everett, Dwayne Eric can be contacted via phone (410) 383-8300.

Contact Information

Primary practice address
1501 Division St Baltimore MD 21217-3121
Phone: (410) 383-8300
Fax: (410) 383-3160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 10227 Maryland
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 10227 Maryland

Profile Details

NPI number 1972662641
LBN Legal business name Everett, Dwayne Eric
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2006
Last updated Apr 19th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972662641 NPPES
Maryland MEDICAID 348734200

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