Aqua Cosmetic and Family Dentistry LLC
NPI #1801286661 in Ellicott City, Maryland
Provider Information
- NPI Number
- 1801286661
- Entity Type
- Organization
- Organization Name
- Aqua Cosmetic and Family Dentistry LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 2, 2015
- Last Updated
- Feb 2, 2015
Practice Location
- Address
- 9011 CHEVROLET DR
- Address 2
- SUITE 9
- City
- Ellicott City
- State
- Maryland
- ZIP Code
- 21042-4024
- Phone
- (410) 750-7051
Authorized Official
- Name
- DR. FARNAZ GHANE, D.D.S
- Title
- CEO
- Phone
- (410) 750-7051
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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