Provider Demographics
NPI:1306067715
Name:VIERTL, GEORGE CAREY (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CAREY
Last Name:VIERTL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-4428
Mailing Address - Country:US
Mailing Address - Phone:410-341-7410
Mailing Address - Fax:
Practice Address - Street 1:560 RIVERSIDE DR
Practice Address - Street 2:SUITE B-206
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4700
Practice Address - Country:US
Practice Address - Phone:410-742-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD131591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice