Individual
DINESH BOPPANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1100 W PATRICK ST, UNIT N, FREDERICK, MD 21703-3902
(240) 457-4246
Mailing address
1100 W PATRICK ST, UNIT N, FREDERICK, MD 21703-3902
(240) 457-4246
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14609
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028083600
—
MD
Enumeration date
11/05/2008
Last updated
03/25/2015
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