Organization
HOLLEH TAJALLI DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOLLEH TAJALLI DDS (OWNER AND DENTIST)
(410) 707-3704
Entity
Organization
Contact information
Practice address
1030 S LINWOOD AVE UNIT 200, BALTIMORE, MD 21224-5091
(410) 707-3704
Mailing address
1633 COVINGTON ST, BALTIMORE, MD 21230-4711
(410) 707-3704
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
15974
MD
Other
Enumeration date
04/12/2018
Last updated
04/08/2019
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