Provider Demographics
NPI:1962954677
Name:DAMIAN, VLAD ALEXANDRU (DDS)
Entity type:Individual
Prefix:
First Name:VLAD
Middle Name:ALEXANDRU
Last Name:DAMIAN
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 1:8203 WINTER SNOW CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-3075
Mailing Address - Country:US
Mailing Address - Phone:301-471-9695
Mailing Address - Fax:
Practice Address - Street 1:8203 WINTER SNOW CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-3075
Practice Address - Country:US
Practice Address - Phone:301-471-9695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041059122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist