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Organization
RAJIV TULADHAR DMD HOLDINGS, PLLC
Active
Organization
RAJIV TULADHAR DMD HOLDINGS, PLLC
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KIM VAN CAMP (PROVIDER RELATIONS SPECIALIST)
(315) 454-6000
Entity
Organization
Contact information
Practice address
516 MARY ESTHER BLVD STE 2, FORT WALTON BEACH, FL 32548
(850) 659-3119
(850) 243-0245
Mailing address
516 MARY ESTHER BLVD, STE 2, FORT WALTON BEACH, FL 32548
(850) 659-3119
(850) 243-0245
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN20980
FL
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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