Individual
MADHUMITHA AMBALAVANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9200 BALTIMORE NATIONAL PIKE, ELLICOTT CITY, MD 21042-2613
(410) 480-9800
Mailing address
9200 BALTIMORE NATIONAL PIKE, ELLICOTT CITY, MD 21042-2613
(606) 454-1052
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14348
MD
Other
Enumeration date
01/13/2010
Last updated
10/27/2023
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