Provider Demographics
NPI:1194947341
Name:WINTER, JOHN DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:WINTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9712 BELAIR RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-1103
Mailing Address - Country:US
Mailing Address - Phone:410-256-6760
Mailing Address - Fax:410-256-4484
Practice Address - Street 1:9712 BELAIR RD
Practice Address - Street 2:SUITE 304
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-1103
Practice Address - Country:US
Practice Address - Phone:410-256-6760
Practice Address - Fax:410-256-4484
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD54041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice