Provider Demographics
NPI:1811016421
Name:BAHAR, AREZOO A (DDS)
Entity Type:Individual
Prefix:
First Name:AREZOO
Middle Name:A
Last Name:BAHAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WESTGATE CIRCLE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:410-268-7100
Mailing Address - Fax:410-269-1329
Practice Address - Street 1:200 WESTGATE CIRCLE
Practice Address - Street 2:SUITE 106
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:410-268-7100
Practice Address - Fax:410-269-1329
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD116181223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics