Provider Demographics
NPI:1306294566
Name:SEWELL, EMILY MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:MARIE
Last Name:SEWELL
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 1:572 RITCHIE HWY STE F
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2966
Mailing Address - Country:US
Mailing Address - Phone:570-498-2177
Mailing Address - Fax:
Practice Address - Street 1:101 RIDGELY AVE STE 12B
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1415
Practice Address - Country:US
Practice Address - Phone:410-267-0766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-28
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD159661223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist