Individual
DR. RAYMOND B. VAN GENNIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
8630 FENTON ST, SUITE 212, SILVER SPRING, MD 20910-3806
(301) 565-8030
Mailing address
8630 FENTON ST, SUITE 212, SILVER SPRING, MD 20910-3806
(301) 565-8030
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12299
MD
Other
Enumeration date
03/11/2007
Last updated
07/08/2007
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