Individual
MRS. CHANNELLE BANGURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
8472 SIMMOND ST, FORT GEORGE G MEADE, MD 20755-5700
(410) 279-4113
Mailing address
1027 CORTANA CT, SEVERN, MD 21144-1185
(410) 279-4113
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
17321
TX
124Q00000X
Dental Hygienist
4121
KY
124Q00000X
Dental Hygienist
Primary
7740
MD
Other
Enumeration date
06/05/2016
Last updated
10/04/2022
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