Organization
HEALTHY DENTAL OF EASTERN AVENUE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHU VENKATA RAMA RAJU NADIMPALLI DDS, MPA (GENERAL DENTIST / OWNER)
(201) 257-7095
Entity
Organization
Contact information
Practice address
7422 EASTERN AVE, BALTIMORE, MD 21224-1923
(410) 888-0888
Mailing address
12233 HAYLAND FARM WAY, ELLICOTT CITY, MD 21042-6027
(201) 257-7095
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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