Provider Demographics
NPI:1720783533
Name:SOWARD, JONATHON BRADLEY II (DDS)
Entity type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:BRADLEY
Last Name:SOWARD
Suffix:II
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 1:138 PENWICK CIR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5106
Mailing Address - Country:US
Mailing Address - Phone:301-712-8756
Mailing Address - Fax:
Practice Address - Street 1:700 PRINCE FREDERICK BLVD # MD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3141
Practice Address - Country:US
Practice Address - Phone:410-414-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD182481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice