Individual
AZITA DAVANLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8180 LARK BROWN ROAD, SUITE #202, ELKRIDGE, MD 21075
(410) 799-7172
(410) 799-7132
Mailing address
2810 PFEFFERKORN ROAD, WEST FRIENDSHIP, MD 21794
(410) 489-9860
(410) 489-9861
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12454
MD
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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