Most Relevant Information
Provider Data
| NPI Number: | 1003216284 |
| Provider Name: | MANASI SUPEKAR |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 15704 |
Most Important Dates
| Enumeration Date: | 08/26/2014 |
| Last Updated: | 03/24/2022 |
Provider Practice Location
3521 12TH ST NE
WASHINGTON
DC
200172545
Practice Location Phone/Fax
| Phone: | 0202450592 |
| Fax: |
Provider Mailing Location
25990 KIMBERLY ROSE DR
CHANTILLY
VA
201523458
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |