Modarres Dental Group

NPI #1891274759 in Ellicott City, Maryland

Provider Information

NPI Number: 1891274759
Entity Type: Organization
Organization Name: Modarres Dental Group
Primary Specialty: Dentist
Enumeration Date: Aug 11, 2018
Last Updated: Aug 11, 2018

Practice Location

Address: 10132 BALTIMORE NATIONAL PIKE STE C
City: Ellicott City
State: Maryland
ZIP Code: 21042-3607
Phone: (410) 465-3224

Authorized Official

Name: DR. ALIREZA MODARRES, DDS, MS
Title: CEO
Phone: (443) 928-9697

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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