Provider Demographics
NPI:1245524073
Name:DAMAS, MYRNELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:MYRNELLE
Middle Name:
Last Name:DAMAS
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 1:5009 HONEYGO CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9828
Mailing Address - Country:US
Mailing Address - Phone:410-248-3384
Mailing Address - Fax:
Practice Address - Street 1:5009 HONEYGO CENTER DR STE 228
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9842
Practice Address - Country:US
Practice Address - Phone:410-248-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD162951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program