Individual
DR. DONITA DYALRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
650 W BALTIMORE ST, SUITE 1401, BALTIMORE, MD 21201-1510
(410) 706-6195
Mailing address
650 W BALTIMORE ST, SUITE 1401, BALTIMORE, MD 21201-1510
(410) 706-6195
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
051467
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
256892
NY
Other
Enumeration date
07/30/2007
Last updated
07/24/2012
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