Organization
SIGNATURE DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRAN NAYUDU DDS (OWNER/DENTIST)
(443) 902-1256
Entity
Organization
Contact information
Practice address
130 THOMAS JOHNSON DR STE 1, FREDERICK, MD 21702-4583
(240) 831-6789
Mailing address
130 THOMAS JOHNSON DR STE 1, FREDERICK, MD 21702-4583
(240) 831-6789
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85340200
—
MD
Enumeration date
02/15/2023
Last updated
02/15/2023
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