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Individual

DR. REZA KESHMIRI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
9 BRONCO CT, GERMANTOWN, MD 20874-6124
(510) 206-4854
Mailing address
9 BRONCO CT, GERMANTOWN, MD 20874-6124
(510) 206-4854

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
15696
MD
122300000X
Dentist
DEN1001440
DC
1223G0001X
General Practice Dentistry
Primary
15696
MD

Other

Enumeration date
09/22/2014
Last updated
11/12/2015
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