A.davanlou Dds,pa

NPI 1013133370 - Dentist - 122300000X

NPI Details
NPI 1013133370
Enumeration Date 04/17/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name AZITA AZITA
Position OWNER
Phone (410) 799-7172
Fax (410) 799-7132
Practice Location
8180 LARK BROWN RD
SUITE 202
ELKRIDGE MD, 21075-6425, US
Phone (410) 799-7172
Fax (410) 799-7132
Business Location
8180 LARK BROWN RD
SUITE 202
ELKRIDGE MD, 21075-6425, US
Phone (410) 799-7172
Fax (410) 799-7132
Toxanomy
Taxonomy Code 122300000X
License State Maryland
License Number 12454
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According to our database, A.davanlou Dds,pa NPI is 1013133370, taxonomy code is 122300000X and license number is 12454, license state is located at Maryland. A.davanlou Dds,pa physically located at 8180 Lark Brown Rd, Elkridge MD, 21075-6425. NPI Number 1033115704 has the healthcare provider type.

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1013133370 NPI number is provided on an as is basis without warranty of any kind. 1013133370 is maintained by the National Plan & Provider Enumeration System. The contents of A.davanlou Dds,pa are for informational purposes only.