Organization
MAIN STREET FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROYA MOAZZEZ D.M.D. (DENTIST)
(301) 519-3100
Entity
Organization
Contact information
Practice address
371 MAIN ST, GAITHERSBURG, MD 20878-5539
(301) 519-3100
(301) 519-3177
Mailing address
371 MAIN ST, GAITHERSBURG, MD 20878-5539
(301) 519-3100
(301) 519-3177
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12651
MD
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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