Organization
SMILESRUSAT SECURITY BLVD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMAN RADPARVAR (PRESIDENT)
(443) 621-2971
Entity
Organization
Contact information
Practice address
6666 SECURITY BLVD, SUIT 11, BALTIMORE, MD 21207-4013
(410) 944-6666
Mailing address
6666 SECURITY BLVD, SUIT 11, BALTIMORE, MD 21207-4013
(410) 944-6666
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14116
MD
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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