Provider Demographics
NPI:1659572881
Name:ATAM, ASUGMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASUGMAN
Middle Name:
Last Name:ATAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 ROCKVILLE PIKE STE 10A
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1142
Mailing Address - Country:US
Mailing Address - Phone:301-424-7150
Mailing Address - Fax:202-595-1371
Practice Address - Street 1:751 ROCKVILLE PIKE STE 10A
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1142
Practice Address - Country:US
Practice Address - Phone:301-424-7150
Practice Address - Fax:202-595-1371
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist