| Olympus Dental Llc | |
|
19231 Montgomery Village Ave Suite D12 Gaithersburg MD 20886-5023 | |
| (240) 780-7002 | |
| (240) 780-7022 |
| Full Name | Olympus Dental Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 19231 Montgomery Village Ave, Gaithersburg, Maryland |
| Authorized Official Name and Position | Naveen Kwatra (PRESIDENT/OWNER) |
| Authorized Official Contact | 2407807002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olympus Dental Llc 19231 Montgomery Village Ave Suite D12 Gaithersburg MD 20886-5023 Ph: (240) 780-7002 | Olympus Dental Llc 19231 Montgomery Village Ave Suite D12 Gaithersburg MD 20886-5023 Ph: (240) 780-7002 |
| NPI Number | 1114344843 |
|---|---|
| Provider Enumeration Date | 03/19/2014 |
| Last Update Date | 10/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114344843 | NPI | - | NPPES |
| 013988200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
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