Individual
TRACY POLESOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OMT, RMT
Contact information
Practice address
17026 YORK RD, PARKTON, MD 21120-9719
(410) 499-9288
Mailing address
16918 DAISY DELL CT, MONKTON, MD 21111-1094
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4753
MD
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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