Healthcare Provider Details

I. General information

NPI: 1376258178
Provider Name (Legal Business Name): FAMILYDENTALGROUPS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 HANOVER PKWY STE 106
GREENBELT MD
20770-2011
US

IV. Provider business mailing address

7500 HANOVER PKWY STE 106
GREENBELT MD
20770-2011
US

V. Phone/Fax

Practice location:
  • Phone: 301-219-7286
  • Fax: 301-474-1660
Mailing address:
  • Phone: 301-219-7286
  • Fax: 301-474-1660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SEYED HAMID TOFIGH
Title or Position: OWNER
Credential: MD
Phone: 301-219-7286