Provider Demographics
NPI:1770901324
Name:NAVEEN KWATRA, DDS, PC
Entity type:Organization
Organization Name:NAVEEN KWATRA, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KWATRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-977-2200
Mailing Address - Street 1:806 W DIAMOND AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1415
Mailing Address - Country:US
Mailing Address - Phone:301-977-2200
Mailing Address - Fax:
Practice Address - Street 1:806 W DIAMOND AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1415
Practice Address - Country:US
Practice Address - Phone:301-977-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty