Individual
TEJAN KHALDON OTTALLAH ELMARIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1820 LANCASTER ST, # 100, BALTIMORE, MD 21231-3584
(410) 970-0440
Mailing address
1820 LANCASTER ST, # 100, BALTIMORE, MD 21231-3584
(410) 970-0440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16093
MD
122300000X
Dentist
21314
FL
Other
Enumeration date
06/30/2015
Last updated
09/10/2015
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