| Columbia Gateway Dentistry | |
|
7226 Lee Deforest Dr #208 Columbia MD 21046-3239 | |
| (410) 872-0104 | |
| (410) 872-0105 |
| Full Name | Columbia Gateway Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 7226 Lee Deforest Dr, Columbia, Maryland |
| Authorized Official Name and Position | Shadi Ghozati (DENTIS/ OWNER) |
| Authorized Official Contact | 4108720104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Gateway Dentistry 7226 Lee Deforest Dr #208 Columbia MD 21046-3239 Ph: (410) 872-0104 | Columbia Gateway Dentistry 7226 Lee Deforest Dr #208 Columbia MD 21046-3239 Ph: (410) 872-0104 |
| NPI Number | 1508091687 |
|---|---|
| Provider Enumeration Date | 05/19/2009 |
| Last Update Date | 05/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508091687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 13298 (Maryland) | Primary |
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