Provider Demographics
NPI:1356321160
Name:CHITRA GUAFARI DDS PC
Entity Type:Organization
Organization Name:CHITRA GUAFARI DDS PC
Other - Org Name:ASTHETIC DENTAL CARE OF KENTLANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHITRA
Authorized Official - Middle Name:TABIBZADEU
Authorized Official - Last Name:GUAFARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-631-9363
Mailing Address - Street 1:60 MARKET ST
Mailing Address - Street 2:#209
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878
Mailing Address - Country:US
Mailing Address - Phone:240-631-9363
Mailing Address - Fax:240-631-9364
Practice Address - Street 1:60 MARKET ST
Practice Address - Street 2:#209
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878
Practice Address - Country:US
Practice Address - Phone:240-631-9363
Practice Address - Fax:240-631-9364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13521122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty