Provider Demographics
NPI:1154523090
Name:SOWELL, SYDNEY BENITA (DDS)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:BENITA
Last Name:SOWELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14420 OLD MILL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3096
Mailing Address - Country:US
Mailing Address - Phone:301-627-6568
Mailing Address - Fax:301-627-5526
Practice Address - Street 1:14420 OLD MILL RD STE 101
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3096
Practice Address - Country:US
Practice Address - Phone:301-627-6568
Practice Address - Fax:301-627-5526
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist