Healthcare Provider Details

I. General information

NPI: 1043819683
Provider Name (Legal Business Name): NORTH WEST DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2020
Last Update Date: 10/24/2020
Certification Date: 10/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3114 GEORGIA AVE NW
WASHINGTON DC
20010-2902
US

IV. Provider business mailing address

3114 GEORGIA AVE NW
WASHINGTON DC
20010-2902
US

V. Phone/Fax

Practice location:
  • Phone: 202-291-1610
  • Fax:
Mailing address:
  • Phone: 202-291-1610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHRAF CHOUDHURY
Title or Position: OWNER
Credential:
Phone: 202-291-1610