Provider Demographics
NPI:1306916903
Name:JENKINS, MARY ANNE (DDS MS)
Entity type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:921 SETON DR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502
Mailing Address - Country:US
Mailing Address - Phone:301-777-8190
Mailing Address - Fax:301-777-3010
Practice Address - Street 1:921 SETON DR
Practice Address - Street 2:STE 1A
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:301-777-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD98371223X0400X
WV31021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics