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Provider Information for 1104901602



DR. DAVID DURAIRAJ KOILPILLAI DDS

Gender: MALE

Individual NPI: 1104901602

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1104901602
Enumeration Date 2006-10-25
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 9811 MALLARD DR #207
LAUREL, MD 20708
United States

Phone: 301-604-0025 | Fax: 240-554-0329
View Map External Link
Primary Practice Address 9811 MALLARD DR SUITE 207
LAUREL, MD 20708
United States

Phone: 301-604-0025 | Fax: 240-554-0329
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist MD 08399