Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Moses Park

Individual provider General Practice Dentistry · NPI 1306539655

Moses Park is a General Practice Dentistry in Severna Park, Maryland. Practices as a sole proprietor. Licensed in Maryland.

Licensed in
MD
In the registry since
2023

Practice location Address checks out

780 Governor Ritchie Hwy Ste 30
Severna Park, MD 21146-4135
Phone: (410) 384-9030
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 18005 (MD)

Record details

NPI number1306539655
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 1, 2023
Last updated in NPPESJune 1, 2023
Certification dateJune 1, 2023
Mailing address13100 Dairymaid Dr, Germantown, MD 20874-2311

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