Provider Demographics
NPI:1780062125
Name:CATONSVILLE ENDODONTICS, LLC
Entity type:Organization
Organization Name:CATONSVILLE ENDODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KUNWAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VIR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-719-7668
Mailing Address - Street 1:405 FREDERICK RD. #160
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:410-719-7668
Mailing Address - Fax:
Practice Address - Street 1:405 FREDERICK RD STE 160
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4633
Practice Address - Country:US
Practice Address - Phone:410-719-7668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD149471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty