MEDICARE: AJMAL DENTAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	12864	MD

General Provider Information

NPI Number	:	1558335950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJMAL DENTAL CARE

Provider Business Mailing Address
First Line	:	10306B BALTIMORE NATIONAL PIKE
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2128
Country	:	US
Telephone Number	:	410-480-3700
Fax Number	:	410-480-1077

Provider Business Practice Location Address
First Line	:	10306B BALTIMORE NATIONAL PIKE
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2128
Country	:	US
Telephone Number	:	410-480-3700
Fax Number	:	410-480-1077

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	DR. NIGHAT AJMAL
Credential	:	DDS
Telephone Number	:	410-480-3700

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	03/27/2008

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Directions to “AJMAL DENTAL CARE ” Practice Location

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