Provider Demographics
NPI:1104940469
Name:PICK, KARL (DDS,MSD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:PICK
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7935 CRAIN HWY S
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4934
Mailing Address - Country:US
Mailing Address - Phone:410-761-6960
Mailing Address - Fax:410-760-8709
Practice Address - Street 1:7935 CRAIN HWY S
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4934
Practice Address - Country:US
Practice Address - Phone:410-761-6960
Practice Address - Fax:410-760-8709
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD42001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5114OtherCAREFIRST
MD670658OtherUCCI