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General NPI Number Information
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NPI Number | 1992379168
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Entity Type | Organization
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Legal Business Name | DREAM SMILES PEDIATRIC DENTISTRY OF GAITHERSBURG
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 818 W DIAMOND AVE STE 220
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1458
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Country | US
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Telephone | 617-763-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 818 W DIAMOND AVE STE 220
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1458
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. FIROUZEH JAMSHIDI
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Credential | DMD
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Telephone | 617-763-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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