Individual
EKPA EYOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
198 THOMAS JOHNSON DR STE 108, FREDERICK, MD 21702-4437
(301) 663-8300
Mailing address
20409 CHERRYSTONE CT, MONTGOMERY VILLAGE, MD 20886-1220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
060648
NY
1223G0001X
General Practice Dentistry
Primary
17040
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2018
Last updated
01/01/2021
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