Provider Demographics
NPI:1891991725
Name:KWATRA, NAVEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAVEEN
Middle Name:
Last Name:KWATRA
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 1:19231 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:SUITE D12
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-5023
Mailing Address - Country:US
Mailing Address - Phone:301-977-2200
Mailing Address - Fax:
Practice Address - Street 1:19231 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:SUITE D12
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20886-5023
Practice Address - Country:US
Practice Address - Phone:301-977-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD142391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry