Gaithersburg Dental Associate PA
NPI #1073654133 in Gaithersburg, Maryland
Provider Information
- NPI Number
- 1073654133
- Entity Type
- Organization
- Organization Name
- Gaithersburg Dental Associate PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 10, 2007
- Last Updated
- Apr 23, 2019
Practice Location
- Address
- 8 RUSSELL AVE
- Address 2
- SUITE 104
- City
- Gaithersburg
- State
- Maryland
- ZIP Code
- 20877-2966
- Phone
- (301) 869-2500
Authorized Official
- Name
- DR. MANDANA GOODARZI LOGMANNI, D.D.S.
- Title
- PRESIDENT
- Phone
- (301) 869-2500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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