Organization
MODARRES DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIREZA MODARRES DDS, MS (CEO)
(443) 928-9697
Entity
Organization
Contact information
Practice address
10132 BALTIMORE NATIONAL PIKE STE C, ELLICOTT CITY, MD 21042-3607
(410) 465-3224
Mailing address
7000 BRAEBURN PL, BETHESDA, MD 20817-4908
(443) 928-9697
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/11/2018
Last updated
08/11/2018
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