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Organization

GAITHERSBURG MODERN DENTISTRY, LLC

Active
Other names
GAITHERSBURG MODERN DENTISTRY
Organization subpart
No

Provider details

NPI number
Authorized official
ALI SHAHRESTANI DMD (OWNER)
(240) 801-3138
Entity
Organization

Contact information

Practice address
812 MUDDY BRANCH RD, GAITHERSBURG, MD 20878-2780
(240) 801-3138
(240) 821-5953
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
07/14/2023
Last updated
07/14/2023
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