Provider Demographics
NPI:1689908766
Name:FOHL, SUZANNE ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:FOHL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 THOMAS JOHNSON DR STE 20
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4454
Mailing Address - Country:US
Mailing Address - Phone:301-698-8200
Mailing Address - Fax:301-698-8201
Practice Address - Street 1:198 THOMAS JOHNSON DR STE 20
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4454
Practice Address - Country:US
Practice Address - Phone:301-698-8200
Practice Address - Fax:301-698-8201
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice