Provider Demographics
NPI:1962415356
Name:EDLAND, BARRY SHELDON (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:SHELDON
Last Name:EDLAND
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 1:801 TOLL HOUSE AVE
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4564
Mailing Address - Country:US
Mailing Address - Phone:301-662-5441
Mailing Address - Fax:301-662-8018
Practice Address - Street 1:801 TOLL HOUSE AVE
Practice Address - Street 2:SUITE C-2
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4564
Practice Address - Country:US
Practice Address - Phone:301-662-5441
Practice Address - Fax:301-662-8018
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD086681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice