Individual
MAKENA KAIULANI RAKOUSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6141 HIGH BRIDGE RD, BOWIE, MD 20720-5216
(301) 262-8024
Mailing address
6141 HIGH BRIDGE RD, BOWIE, MD 20720-5216
(301) 262-8024
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18196
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2023
Last updated
08/21/2024
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