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General NPI Number Information
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NPI Number | 1245885284
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Entity Type | Individual
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Provider Name | MANA SHOEYBI DDS
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Gender | Female
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Dates
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Enumeration Date | 08/06/2019
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 6955 OAKLAND MILLS RD STE 0
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City | COLUMBIA
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State | MD
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Zip | 21045-5849
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Country | US
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Telephone | 410-480-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 5661 PHELPS LUCK DR
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City | COLUMBIA
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State | MD
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Zip | 21045-2526
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Country | US
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Telephone | 240-848-0112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16943
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License Number State | MD
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