A.Davanlou DDS,pa
Dentist in Elkridge, MD. Organization (NPI-2).
NPI number1013133370
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1013133370
- Entity type
- Organization (NPI-2)
- Legal business name
- A.Davanlou DDS,pa
- Organization subpart
- No
- Enumeration date
- Apr 17, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 12454 | MD | Yes |
Other names
- Chartwell Dental Group (Doing Business As)
Practice location
8180 Lark Brown RdSuite 202
Elkridge, MD 21075-6425
Phone 410-799-7172 · Fax 410-799-7132
Mailing address
8180 Lark Brown RdSuite 202
Elkridge, MD 21075-6425
Phone 410-799-7172 · Fax 410-799-7132
Authorized official
Azita Davanlou
Owner
4107997172
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