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General NPI Number Information
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NPI Number | 1467684035
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Entity Type | Organization
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Legal Business Name | DHARANI JASTHI DMD PC
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Dates
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Enumeration Date | 08/17/2009
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Last Update Date | 08/17/2009
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Provider Practice Location Address
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Address Line | 832 N ROLLING RD
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City | CATONSVILLE
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State | MD
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Zip | 21228-4136
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Country | US
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Telephone | 410-744-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 832 N ROLLING RD
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City | CATONSVILLE
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State | MD
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Zip | 21228-4136
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Country | US
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Telephone | 410-744-7777
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DHARANI JASTHI
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Credential | DMD
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Telephone | 443-413-5458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12210
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License Number State | MD
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