Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 14369 | MD |
NPI | 1083927362 |
---|---|
Provider Name | Dr. Laleh Abdolazadeh |
First Address | Bethesda, MD 20889-5600 |
Second Address | Bethesda, MD 20889-5600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2010 |
Last Update Date | 15/07/2010 |