Provider Demographics
NPI:1316379506
Name:AKASH AGRAWAL DDS PC
Entity Type:Organization
Organization Name:AKASH AGRAWAL DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AKASH
Authorized Official - Middle Name:
Authorized Official - Last Name:AGRAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-283-6211
Mailing Address - Street 1:3165 WOOSTER DR
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-3023
Mailing Address - Country:US
Mailing Address - Phone:301-283-6211
Mailing Address - Fax:301-283-5323
Practice Address - Street 1:3165 WOOSTER DR
Practice Address - Street 2:
Practice Address - City:BRYANS ROAD
Practice Address - State:MD
Practice Address - Zip Code:20616-3023
Practice Address - Country:US
Practice Address - Phone:301-283-6211
Practice Address - Fax:301-283-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15281122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty