Provider Demographics
NPI:1366568792
Name:LANG, MARTIN THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:THOMAS
Last Name:LANG
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 1:12185 WOODFORD DR
Mailing Address - Street 2:
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104-1456
Mailing Address - Country:US
Mailing Address - Phone:410-442-1501
Mailing Address - Fax:
Practice Address - Street 1:1407 YORK RD
Practice Address - Street 2:STE 204
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6042
Practice Address - Country:US
Practice Address - Phone:410-821-6458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD59161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics