Provider Demographics
NPI:1922164060
Name:SARFARAZ, LALEH (DDS)
Entity Type:Individual
Prefix:
First Name:LALEH
Middle Name:
Last Name:SARFARAZ
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 1:12800 MIDDLEBROOK RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5204
Mailing Address - Country:US
Mailing Address - Phone:301-353-8890
Mailing Address - Fax:301-515-9101
Practice Address - Street 1:12800 MIDDLEBROOK RD
Practice Address - Street 2:SUITE 104
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5204
Practice Address - Country:US
Practice Address - Phone:301-353-8890
Practice Address - Fax:301-515-9101
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD118781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice