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Organization

A.DAVANLOU DDS,PA

Active
Other names
chartwell dental group
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AZITA DAVANLOU DDS (OWNER)
(410) 799-7172
Entity
Organization

Contact information

Practice address
8180 LARK BROWN RD, SUITE 202, ELKRIDGE, MD 21075-6425
(410) 799-7172
(410) 799-7132
Mailing address
8180 LARK BROWN RD, SUITE 202, ELKRIDGE, MD 21075-6425
(410) 799-7172
(410) 799-7132

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12454
MD

Other

Enumeration date
04/17/2007
Last updated
08/22/2020
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