Individual
KELLY GANZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8955 WOOD ROAD, BUILDING 1, BETHESDA, MD 20899
(301) 295-0064
Mailing address
8015 OLD GEORGETOWN RD APT 737, BETHESDA, MD 20814-2590
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12324093-9922
UT
122300000X
Dentist
Primary
1922679943
UT
Other
Enumeration date
07/09/2021
Last updated
07/15/2026
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