Individual
INDRA SIDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
595 MAIN ST, SUITE 237, LAUREL, MD 20707-4352
(301) 498-0002
Mailing address
595 MAIN ST, SUITE 237, LAUREL, MD 20707-4352
(301) 498-0002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11295
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11295
STATE LICENCE
MD
Enumeration date
09/26/2008
Last updated
09/26/2008
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