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General NPI Number Information
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NPI Number | 1477938926
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Entity Type | Individual
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Provider Name | SVETLIN PENCHEV DMD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 8955 WOOD RD BUILDING 1, OFFICE 2414
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City | BETHESDA
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State | MD
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Zip | 20889-5628
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Country | US
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Telephone | 301-400-0946
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Fax |
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Provider Business Mailing Address
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Address Line | 3446 CONNECTICUT AVE NW APT 100
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City | WASHINGTON
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State | DC
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Zip | 20008-1313
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Country | US
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Telephone | 706-414-3860
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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 | DN014967
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License Number State | GA
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