Organization
AQUA COSMETIC AND FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARNAZ GHANE D.D.S (CEO)
(410) 750-7051
Entity
Organization
Contact information
Practice address
9011 CHEVROLET DR, SUITE 9, ELLICOTT CITY, MD 21042-4024
(410) 750-7051
Mailing address
9011 CHEVROLET DR, SUITE 9, ELLICOTT CITY, MD 21042-4024
(410) 750-7051
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13285
MD
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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