Individual
ANDREA PELLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3319 W BELVEDERE AVE, BALTIMORE, MD 21215-5143
(410) 542-7800
(410) 542-2039
Mailing address
6005 BELLE GROVE RD, BALTIMORE, MD 21225-3261
(410) 919-8278
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7148
MD
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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