Provider Demographics
NPI:1902164635
Name:DOHMAN, LUKE SAMUEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:SAMUEL
Last Name:DOHMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 PRINCE FREDERICK BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3199
Mailing Address - Country:US
Mailing Address - Phone:443-968-8575
Mailing Address - Fax:443-432-0082
Practice Address - Street 1:995 PRINCE FREDERICK BLVD STE 108
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3199
Practice Address - Country:US
Practice Address - Phone:443-968-8575
Practice Address - Fax:443-432-0082
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1646351223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty