Healthcare Provider Details

I. General information

NPI: 1538327887
Provider Name (Legal Business Name): RAMESH C SARDANA D.D.S.,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 STEMMERS RUN RD SUITE B
BALTIMORE MD
21221-3334
US

IV. Provider business mailing address

617 STEMMERS RUN RD SUITE B
BALTIMORE MD
21221-3334
US

V. Phone/Fax

Practice location:
  • Phone: 410-687-3608
  • Fax: 410-997-1128
Mailing address:
  • Phone: 410-687-3608
  • Fax: 410-997-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4644
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: