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General NPI Number Information
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NPI Number | 1356321160
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Entity Type | Organization
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Legal Business Name | CHITRA GUAFARI DDS PC
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 60 MARKET ST #209
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City | GAITHERSBURG
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State | MD
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Zip | 20878
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Country | US
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Telephone | 240-631-9363
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Fax | 240-631-9364
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Provider Business Mailing Address
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Address Line | 60 MARKET ST #209
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City | GAITHERSBURG
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State | MD
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Zip | 20878
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Country | US
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Telephone | 240-631-9363
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Fax | 240-631-9364
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Authorized Official
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Title or Position | OWNER
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Name | CHITRA TABIBZADEU GUAFARI
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Credential | DDS
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Telephone | 240-631-9363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13521
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License Number State | MD
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