Healthcare Provider Details

I. General information

NPI: 1114186681
Provider Name (Legal Business Name): TOFIGHS ASSCOCIATE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14301 LAYHILL RD STE 102
SILVER SPRING MD
20906-1937
US

IV. Provider business mailing address

14301 LAYHILL RD STE 102
SILVER SPRING MD
20906-1937
US

V. Phone/Fax

Practice location:
  • Phone: 301-438-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11510
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12802
License Number StateMD

VIII. Authorized Official

Name: AMIR TOFIGH
Title or Position: DENTIST
Credential:
Phone: 301-219-1503