Basic Information
| Provider Information | |||||||||
| NPI: | 1710078852 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WITT | ||||||||
| FirstName: | DARYL | ||||||||
| MiddleName: | BAYARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5066 | ||||||||
| Address2: | |||||||||
| City: | LAYTONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019778855 | ||||||||
| FaxNumber: | 3019778856 | ||||||||
| Practice Location | |||||||||
| Address1: | 6835 OLNEY LAYTONSVILLE ROAD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LAYTONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019778855 | ||||||||
| FaxNumber: | 3019778856 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 05933 | MD | Y | Dental Providers | Dentist | General Practice |
No ID Information.