Individual
DR. MANASI SUPEKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3521 12TH ST NE, WASHINGTON, DC 20017-2545
(020) 245-0592
Mailing address
25990 KIMBERLY ROSE DR, CHANTILLY, VA 20152-3458
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401417821
VA
1223G0001X
General Practice Dentistry
Primary
15704
MD
1223G0001X
General Practice Dentistry
DEN1001442
DC
Other
Enumeration date
08/26/2014
Last updated
03/24/2022
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