Individual
SANJAR KHODJAEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
23140 MOAKLEY ST STE 5, LEONARDTOWN, MD 20650-2931
(301) 475-2881
Mailing address
23140 MOAKLEY ST STE 5, LEONARDTOWN, MD 20650-2931
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401416590
VA
122300000X
Dentist
Primary
16991
MD
Other
Enumeration date
06/27/2019
Last updated
07/10/2019
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