| Mukkara Hagerstown Llc | |
|
322 E Antietam St Ste 103 Hagerstown MD 21740-5736 | |
| (301) 733-1552 | |
| (301) 733-1553 |
| Full Name | Mukkara Hagerstown Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 322 E Antietam St Ste 103, Hagerstown, Maryland |
| Authorized Official Name and Position | Mamata Mukkara (ORTHODONTIST) |
| Authorized Official Contact | 6174802348 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mukkara Hagerstown Llc 7 Kilglass Ct Apt 102 Lutherville Timonium MD 21093-7782 Ph: (617) 480-2348 | Mukkara Hagerstown Llc 322 E Antietam St Ste 103 Hagerstown MD 21740-5736 Ph: (301) 733-1552 |
| NPI Number | 1164094330 |
|---|---|
| Provider Enumeration Date | 07/15/2021 |
| Last Update Date | 07/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164094330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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