Healthcare Provider Details

I. General information

NPI: 1336359504
Provider Name (Legal Business Name): KUNWAR VIR D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 FREDERICK RD STE 160
CATONSVILLE MD
21228-4633
US

IV. Provider business mailing address

405 FREDERICK RD STE 160
CATONSVILLE MD
21228-4633
US

V. Phone/Fax

Practice location:
  • Phone: 410-980-3380
  • Fax:
Mailing address:
  • Phone: 410-980-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number14947
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: