Healthcare Provider Details

I. General information

NPI: 1447214820
Provider Name (Legal Business Name): ARIF MASOOD BDS, MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1286 MD ROUTE 3 SOUTH STE 7
CROFTON MD
21114-1339
US

IV. Provider business mailing address

926 GREAT POND DR SUITE 2003
ALTAMONTE SPRINGS FL
32714-7244
US

V. Phone/Fax

Practice location:
  • Phone: 410-721-8200
  • Fax: 410-721-7629
Mailing address:
  • Phone: 407-788-6533
  • Fax: 407-788-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12091
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number12091
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: