Organization
FARIBA RAFIZADEH, D.M.D. P.A.
Active
Other names
Quince Orchard Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARIBA RAFIZADEH D.M.D. (DENTIST OWNER)
(301) 948-5656
Entity
Organization
Contact information
Practice address
902 WIND RIVER LN STE 204, GAITHERSBURG, MD 20878-1977
(301) 948-5656
(301) 519-9164
Mailing address
902 WIND RIVER LN STE 204, GAITHERSBURG, MD 20878-1977
(301) 948-5656
(301) 519-9164
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12428
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12428
MARYLAND STATE LICENSE
MD
Enumeration date
03/26/2007
Last updated
08/22/2020
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