Individual
DR. MOHAMMAD - IZADIDEHKORDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
12209 TULLAMORE RD, TIMONIUM, MD 21093-7816
(410) 560-0360
(410) 560-0364
Mailing address
11400 LAKE POTOMAC DR, POTOMAC, MD 20854-1216
(301) 983-0818
(301) 983-0650
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0401008006
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11080
MD
Other
Enumeration date
07/17/2006
Last updated
11/05/2021
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