Organization
SUBURBAN DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMTIAZ NOOR D.D.S. (PRESIDENT)
(301) 947-3131
Entity
Organization
Contact information
Practice address
106 SOUTH FREDERICK AVENUE, GAITHERSBURG, MD 20877-2312
(301) 947-3131
(301) 947-0461
Mailing address
106 SOUTH FREDERICK AVENUE, GAITHERSBURG, MD 20877
(301) 947-3131
(301) 947-0461
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11653
MD
Other
Enumeration date
07/21/2008
Last updated
07/21/2008
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