Provider Demographics
NPI:1265257729
Name:WENDY DAULAT, DDS LLC
Entity type:Organization
Organization Name:WENDY DAULAT, DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PEDIATRIC DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAULAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:443-398-5911
Mailing Address - Street 1:4149 SHARP RD
Mailing Address - Street 2:
Mailing Address - City:GLENELG
Mailing Address - State:MD
Mailing Address - Zip Code:21737-9526
Mailing Address - Country:US
Mailing Address - Phone:443-398-5911
Mailing Address - Fax:410-988-3211
Practice Address - Street 1:4149 SHARP RD
Practice Address - Street 2:
Practice Address - City:GLENELG
Practice Address - State:MD
Practice Address - Zip Code:21737-9526
Practice Address - Country:US
Practice Address - Phone:443-398-5911
Practice Address - Fax:410-988-3211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental