Individual
ATEFEH REZAEI BOROUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13600 BALTIMORE AVE STE 200, LAUREL, MD 20707-9495
(301) 470-2137
Mailing address
113 ELLINGTON BLVD APT 417, GAITHERSBURG, MD 20878-4529
(703) 984-9903
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
17161
MD
Other
Enumeration date
07/17/2020
Last updated
07/17/2020
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