Basic Information
| Provider Information | |||||||||
| NPI: | 1942748363 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MD DENTAL CENTER PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3905 NEBRASKA AVE | ||||||||
| Address2: | UNIT C1 | ||||||||
| City: | LEVITTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190563333 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4063 MINNESOTA AVE NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200193541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022901409 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2017 | ||||||||
| LastUpdateDate: | 02/06/2017 | ||||||||
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| AuthorizedOfficialLastName: | ARORA | ||||||||
| AuthorizedOfficialFirstName: | VIKAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2157851100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | Y | 193400000X SINGLE SPECIALTY GROUP | Dental Providers | Dentist | General Practice |
No ID Information.