Provider Demographics
NPI:1427268325
Name:SOMERVILLE, DAVID MORRIS (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MORRIS
Last Name:SOMERVILLE
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 1:198 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4398
Mailing Address - Country:US
Mailing Address - Phone:301-663-8300
Mailing Address - Fax:301-682-3993
Practice Address - Street 1:198 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 108
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4398
Practice Address - Country:US
Practice Address - Phone:301-663-8300
Practice Address - Fax:301-682-3993
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7539122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist