Individual
MS. TANIA CHIMWEMWE NKUNGULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1401 MERCANTILE LN, SUITE 102, LARGO, MD 20774-4301
(301) 341-0041
(301) 341-0014
Mailing address
1401 MERCANTILE LN, SUITE 102, LARGO, MD 20774-4301
(301) 341-0041
(301) 341-0014
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14426
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN1000908
DC
Other
Enumeration date
10/17/2005
Last updated
02/12/2025
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