Individual
SUMANYA VENKAT RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 EDMONDSON AVE, BALTIMORE, MD 21229
(443) 540-6007
Mailing address
350 N.CLARK STREET, DENTAL DREAMS LLC ℅ JULIETTE BOYCE, CHICAGO, IL 60654
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414649
VA
Other
Enumeration date
10/21/2014
Last updated
11/14/2014
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