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Organization
FARIBA RAFIZADEH, D.M.D. P.A.
Active
Organization
FARIBA RAFIZADEH, D.M.D. P.A.
Active
Other names
Quince Orchard Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARIBA RAFIZADEH D.M.D. (DENTIST OWNER)
(301) 948-5656
Entity
Organization
Contact information
Practice address
902 WIND RIVER LN STE 204, GAITHERSBURG, MD 20878-1977
(301) 948-5656
(301) 519-9164
Mailing address
902 WIND RIVER LN STE 204, GAITHERSBURG, MD 20878-1977
(301) 948-5656
(301) 519-9164
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12428
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12428
MARYLAND STATE LICENSE
MD
Enumeration date
03/26/2007
Last updated
08/22/2020
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