Organization
MONDAWMIN MALL DENTAL LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSTISLAV KRAZNOV (OWNER)
(786) 475-7600
Entity
Organization
Contact information
Practice address
2401 LIBERTY HEIGHTS AVE, STE 3725, BALTIMORE, MD 21215-8019
(410) 225-0014
Mailing address
2401 LIBERTY HEIGHTS AVE, STE 3725, BALTIMORE, MD 21215-8019
(410) 225-0014
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/13/2008
Last updated
12/04/2014
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