Provider Demographics
NPI:1033897855
Name:PUJA AGARWAL DDS PC
Entity type:Organization
Organization Name:PUJA AGARWAL DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-247-5518
Mailing Address - Street 1:8609 WILD OLIVE DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3439
Mailing Address - Country:US
Mailing Address - Phone:425-247-5518
Mailing Address - Fax:
Practice Address - Street 1:18209 FLOWER HILL WAY # A
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-5331
Practice Address - Country:US
Practice Address - Phone:425-247-5518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty