Individual
DR. ALI REZA ELYASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7525 GREENWAY CENTER DR, SUITE 109, GREENBELT, MD 20770-3509
(301) 982-4555
(301) 982-4557
Mailing address
7525 GREENWAY CENTER DR, SUITE 109, GREENBELT, MD 20770-3509
(301) 982-4555
(301) 982-4557
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13731
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DT-2283
HI
Other
Enumeration date
12/07/2005
Last updated
10/09/2015
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