Provider Demographics
NPI:1699780387
Name:SCERBA, MICHAEL TERENCE SR (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TERENCE
Last Name:SCERBA
Suffix:SR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:5411 OLD FREDERICK RD
Mailing Address - Street 2:SUITE 3, FREDERICK VILLA PROFESSIONAL CENTER
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-2195
Mailing Address - Country:US
Mailing Address - Phone:410-744-6565
Mailing Address - Fax:410-747-9948
Practice Address - Street 1:5411 OLD FREDERICK RD
Practice Address - Street 2:SUITE 3, FREDERICK VILLA PROFESSIONAL CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-2195
Practice Address - Country:US
Practice Address - Phone:410-744-6565
Practice Address - Fax:410-747-9948
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD52331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice