Provider Demographics
NPI:1659971711
Name:MONTPELIER FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:MONTPELIER FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KOILPILLAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-604-0025
Mailing Address - Street 1:14502 GREENVIEW DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3221
Mailing Address - Country:US
Mailing Address - Phone:301-604-0025
Mailing Address - Fax:240-554-0329
Practice Address - Street 1:14502 GREENVIEW DR STE 100
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3221
Practice Address - Country:US
Practice Address - Phone:301-604-0025
Practice Address - Fax:240-554-0329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies