Individual
DR. ALI REZA EGHTESADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8363 CHERRY LN, LAUREL, MD 20707-4831
(301) 980-8293
Mailing address
13 CROWNSGATE CT, GERMANTOWN, MD 20874-4423
(301) 412-2818
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
13566
MD
Other
Enumeration date
07/23/2007
Last updated
08/09/2007
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