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General NPI Number Information
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NPI Number | 1124509518
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Entity Type | Organization
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Legal Business Name | TONTESH TAWADY, LLC
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 208 FULFORD AVE
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City | BEL AIR
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State | MD
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Zip | 21014-3814
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Country | US
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Telephone | 410-836-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 208 FULFORD AVE
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City | BEL AIR
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State | MD
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Zip | 21014-3814
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Country | US
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Telephone | 410-836-7800
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Fax |
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Authorized Official
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Title or Position | DENTIST/ENDODONTIST
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Name | DR. TONTESH SHIVAKUMAR TAWADY
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Credential |
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Telephone | 410-836-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 15727
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License Number State | MD
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