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Organization
SHADI GHOZATI D.D.S. PA
Active
Organization
SHADI GHOZATI D.D.S. PA
Active
Other names
Columbia Gateway Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHADI GHOZATI D.D.S (DENTIS/ OWNER)
(410) 872-0104
Entity
Organization
Contact information
Practice address
7226 LEE DEFOREST DR, #208, COLUMBIA, MD 21046-3239
(410) 872-0104
(410) 872-0105
Mailing address
7226 LEE DEFOREST DR, #208, COLUMBIA, MD 21046-3239
(410) 872-0104
(410) 872-0105
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13298
MD
Other
Enumeration date
05/19/2009
Last updated
05/19/2009
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