Provider Demographics
NPI:1053610352
Name:HARRY Y. CANTER, JR. D.D.S PA
Entity type:Organization
Organization Name:HARRY Y. CANTER, JR. D.D.S PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CANTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-822-1183
Mailing Address - Street 1:556 C CYNWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3886
Mailing Address - Country:US
Mailing Address - Phone:410-822-1183
Mailing Address - Fax:
Practice Address - Street 1:556 C CYNWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3886
Practice Address - Country:US
Practice Address - Phone:410-822-1183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD072911223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDV207Medicare UPIN