Organization
HEALTHY DENTAL OF BALTIMORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADHU VENKATA RAMA RAJU NADIMPALLI DDS, MPA (OWNER/ GENERAL DENTIST)
(201) 257-7095
Entity
Organization
Contact information
Practice address
2103 W PATAPSCO AVE, BALTIMORE, MD 21230-2946
(410) 888-4000
Mailing address
7605 GOLDEN SLUMBER LN, ELKRIDGE, MD 21075-7602
(201) 257-7095
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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