MEDICARE: ARIF MASOOD BDS, MSD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12091	MD
2	1223P0221X	Pediatric Dentistry	12091	MD

General Provider Information

NPI Number	:	1447214820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIF MASOOD BDS, MSD

Provider Business Mailing Address
First Line	:	926 GREAT POND DR
Second Line	:	SUITE 2003
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-7244
Country	:	US
Telephone Number	:	407-788-6533
Fax Number	:	407-788-3572

Provider Business Practice Location Address
First Line	:	1286 MD ROUTE 3 SOUTH STE 7
Second Line	:
City	:	CROFTON
State	:	MD
Zip	:	21114-1339
Country	:	US
Telephone Number	:	410-721-8200
Fax Number	:	410-721-7629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	04/05/2012

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