Organization
SHADI GHOZATI D.D.S. PA
Active
Other names
Columbia Gateway Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHADI GHOZATI D.D.S (DENTIS/ OWNER)
(410) 872-0104
Entity
Organization
Contact information
Practice address
7226 LEE DEFOREST DR, #208, COLUMBIA, MD 21046-3239
(410) 872-0104
(410) 872-0105
Mailing address
7226 LEE DEFOREST DR, #208, COLUMBIA, MD 21046-3239
(410) 872-0104
(410) 872-0105
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13298
MD
Other
Enumeration date
05/19/2009
Last updated
05/19/2009
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