Individual
DR. STEVEN ROBERT KISHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Contact information
Practice address
11404 OLD GEORGETOWN RD, SUITE 104, ROCKVILLE, MD 20852-2865
(301) 984-9111
(301) 984-0374
Mailing address
11404 OLD GEORGETOWN RD, SUITE 104, ROCKVILLE, MD 20852-2865
(301) 984-9111
(301) 984-0374
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8776
MD
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
D0041703
MD
Other
Enumeration date
02/02/2011
Last updated
08/04/2011
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