Individual
DR. DMITRIY ITSKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
481 N FREDERICK AVE STE 104, GAITHERSBURG, MD 20877-2470
(301) 926-1407
(301) 926-9035
Mailing address
481 N FREDERICK AVE STE 104, GAITHERSBURG, MD 20877-2470
(301) 926-1407
(301) 926-9035
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12967
MD
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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