Provider Demographics
NPI:1801494257
Name:WILHELM, CHRISTINA ANN (RDH)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANN
Last Name:WILHELM
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3160 LORING DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20639-4205
Mailing Address - Country:US
Mailing Address - Phone:443-990-2110
Mailing Address - Fax:
Practice Address - Street 1:3150 W WARD RD STE 304
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3057
Practice Address - Country:US
Practice Address - Phone:410-257-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDH7369124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist