Organization
WHEATON MALL DENTAL LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSTISLAV KRASNOV DDS (DENTIST)
(410) 933-9300
Entity
Organization
Contact information
Practice address
11160 VEIRS MILL RD SPC 168, WHEATON, MD 20902-5913
(410) 933-9300
Mailing address
11160 VEIRS MILL RD SPC 168, WHEATON, MD 20902-5913
(410) 933-9300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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