Provider Demographics
NPI:1093705451
Name:PUROHIT, ATUL P (DDS)
Entity Type:Individual
Prefix:DR
First Name:ATUL
Middle Name:P
Last Name:PUROHIT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 TOLL HOUSE AVE
Mailing Address - Street 2:FREDERICK MEDICAL CENTER, BLDG I
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4564
Mailing Address - Country:US
Mailing Address - Phone:301-662-0131
Mailing Address - Fax:
Practice Address - Street 1:801 TOLL HOUSE AVE
Practice Address - Street 2:FREDERICK MEDICAL CENTER, BLDG I
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4564
Practice Address - Country:US
Practice Address - Phone:301-662-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice