MEDICARE: MANPREET K DHILLON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	16264	MD

General Provider Information

NPI Number	:	1922506260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANPREET K DHILLON DDS

Provider Business Mailing Address
First Line	:	7500 MONTPELIER RD STE 108
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20723-6012
Country	:	US
Telephone Number	:	301-617-0880
Fax Number	:	301-617-0880

Provider Business Practice Location Address
First Line	:	7500 MONTPELIER RD STE 108
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20723-6012
Country	:	US
Telephone Number	:	301-617-0880
Fax Number	:	301-617-0880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2018
Last Update Date	:	01/31/2018

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