Organization
KIDZ & FAMILY DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PARISA NEMATI (OWNER)
(954) 826-8785
Entity
Organization
Contact information
Practice address
11933 GEORGIA AVE, WHEATON, MD 20902
(954) 826-8785
Mailing address
11933 GEORGIA AVE, WHEATON, MD 20902
(954) 826-8785
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
15167
MD
261QD0000X
Dental Clinic/Center
Primary
15191
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061340100
—
MD
05
—
669761334
—
MD
Enumeration date
12/11/2014
Last updated
12/11/2014
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