Provider Demographics
NPI:1871788430
Name:ORAL MEDICINE CONSULTANTS
Entity type:Organization
Organization Name:ORAL MEDICINE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ORAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MEILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PHD
Authorized Official - Phone:410-706-7625
Mailing Address - Street 1:650 W BALTIMORE ST
Mailing Address - Street 2:ROOM 7251
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1510
Mailing Address - Country:US
Mailing Address - Phone:410-706-7625
Mailing Address - Fax:410-706-0519
Practice Address - Street 1:650 W BALTIMORE ST
Practice Address - Street 2:ROOM 7251
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1510
Practice Address - Country:US
Practice Address - Phone:410-706-7625
Practice Address - Fax:410-706-0519
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UMFDSP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD59211223P0106X
261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Multi-Specialty
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncologyGroup - Multi-Specialty