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General NPI Number Information
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NPI Number | 1366819054
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Entity Type | Individual
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Provider Name | SULEKHA AGRAWAL DMD
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Gender | Female
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 01/22/2020
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Provider Practice Location Address
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Address Line | 9194 RED BRANCH RD
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City | COLUMBIA
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State | MD
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Zip | 21045-2005
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Country | US
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Telephone | 104-730-0011
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Fax | 410-730-0199
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Provider Business Mailing Address
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Address Line | 11145 MARTHA WAY
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City | FULTON
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State | MD
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Zip | 20759-2214
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Country | US
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Telephone | 917-319-3491
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16386
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License Number State | MD
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