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General NPI Number Information
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NPI Number | 1811100167
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Entity Type | Organization
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Legal Business Name | RND DENTAL
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 481 N FREDERICK AVE #104
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City | GAITHERSBURG
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State | MD
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Zip | 20877
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Country | US
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Telephone | 301-926-1407
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Fax | 301-926-9035
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Provider Business Mailing Address
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Address Line | 481 N FREDERICK AVE #104
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City | GAITHERSBURG
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State | MD
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Zip | 20877
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Country | US
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Telephone | 301-926-1407
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Fax | 301-926-9035
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Authorized Official
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Title or Position | DENTIST
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Name | REGINA STRYAPKO
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Credential | DDS
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Telephone | 301-296-1407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12969
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License Number State | MD
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