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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
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist MD 08399
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location