Provider Demographics
NPI:1982988010
Name:PAYAM NOURMAND DDS PC
Entity Type:Organization
Organization Name:PAYAM NOURMAND DDS PC
Other - Org Name:HARFORD DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NOURMAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-838-7162
Mailing Address - Street 1:724 ROCK SPRING RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2945
Mailing Address - Country:US
Mailing Address - Phone:410-838-7162
Mailing Address - Fax:
Practice Address - Street 1:724 ROCK SPRING RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2945
Practice Address - Country:US
Practice Address - Phone:410-838-7162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14008122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty