Individual
MANALI A VAIDYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4510 EDMONDSON AVE, BALTIMORE, MD 21229
(410) 233-5777
Mailing address
DENTAL DREAMS LLC, C/O MARINA MILLER, 350 N. CLARK STREET, 6TH FLOOR, CHICAGO, IL 60654
(312) 274-4524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16482
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
MD
Other
Enumeration date
06/12/2018
Last updated
07/01/2018
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