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General NPI Number Information
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NPI Number | 1174845002
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Entity Type | Individual
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Provider Name | VIGEN SIMCHIAN DDS
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Gender | Male
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Dates
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Enumeration Date | 02/19/2010
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 19103 WHEATFIELD DR.
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City | GERMANTOWN
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State | MD
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Zip | 20876
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Country | US
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Telephone | 240-426-7335
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Fax |
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Provider Business Mailing Address
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Address Line | 19103 WHEATFIELD DR
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City | GERMANTOWN
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State | MD
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Zip | 20876-1730
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Country | US
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Telephone | 240-426-7335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13322
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License Number State | MD
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