Organization
OLYMPUS DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAVEEN KWATRA DDS (PRESIDENT/OWNER)
(240) 780-7002
Entity
Organization
Contact information
Practice address
19231 MONTGOMERY VILLAGE AVE, SUITE D12, GAITHERSBURG, MD 20886-5023
(240) 780-7002
(240) 780-7022
Mailing address
19231 MONTGOMERY VILLAGE AVE, SUITE D12, GAITHERSBURG, MD 20886-5023
(240) 780-7002
(240) 780-7022
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013988200
—
MD
Enumeration date
03/19/2014
Last updated
10/06/2014
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