| Tom Fenlon Dds Pc | |
|
12800 Frederick Rd Suite 102 West Friendship MD 21794-9564 | |
| (410) 442-2800 | |
| Not Available |
| Full Name | Tom Fenlon Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 12800 Frederick Rd, West Friendship, Maryland |
| Authorized Official Name and Position | Thomas J Fenlon (PRESIDENT/OWNER) |
| Authorized Official Contact | 4104422800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tom Fenlon Dds Pc Po Box 340 West Friendship MD 21794-0340 Ph: (410) 442-2800 | Tom Fenlon Dds Pc 12800 Frederick Rd Suite 102 West Friendship MD 21794-9564 Ph: (410) 442-2800 |
| NPI Number | 1548638430 |
|---|---|
| Provider Enumeration Date | 09/09/2015 |
| Last Update Date | 09/28/2022 |
| Medicare PECOS PAC ID | 9335441013 |
|---|---|
| Medicare Enrollment ID | O20160112003183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548638430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 5942 (Maryland) | Secondary |