| Mary Teddy Wray Dds Dba Towson Extreme Smiles | |
|
8501 Lasalle Rd Suite 306 Towson MD 21286-5914 | |
| (410) 296-7599 | |
| (410) 583-9185 |
| Full Name | Mary Teddy Wray Dds Dba Towson Extreme Smiles |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8501 Lasalle Rd, Towson, Maryland |
| Authorized Official Name and Position | Mary Teddy Wray (OWNER) |
| Authorized Official Contact | 4102967599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Teddy Wray Dds Dba Towson Extreme Smiles 8501 Lasalle Rd Suite 306 Towson MD 21286-5914 Ph: (410) 296-7599 | Mary Teddy Wray Dds Dba Towson Extreme Smiles 8501 Lasalle Rd Suite 306 Towson MD 21286-5914 Ph: (410) 296-7599 |
| NPI Number | 1932235306 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932235306 | NPI | - | NPPES |
| 55774 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10773 (Maryland) | Primary |
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