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Individual

AAKASH CHAMU MUDALIAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BDS, MHA, DMD, FICOI

Contact information

Practice address
605 POST OFFICE RD STE 203, WALDORF, MD 20602-1913
(301) 843-3444
Mailing address
605 POST OFFICE RD STE 203, WALDORF, MD 20602-1913
(301) 843-3444

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16900
MD
1223G0001X
General Practice Dentistry
DEN2000140
DC
1223G0001X
General Practice Dentistry
DS041461
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16900
MARYLAND DEPARTMENT OF HEALTH
MD
01
DEN2000140
THE DISTRICT OF COLUMBIA BOARD OF DENTISTRY
DC
01
DS041461
DENTAL LICENSE
PA
Enumeration date
07/17/2017
Last updated
06/08/2022
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