NPI 1003233156

Maryam Roosta, DDS

Practitioner General Practice Dentistry Ellicott City, MD

Practice location

Address: 9335 Baltimore National Pike, Ellicott City, MD 21042-2801
Phone: (410) 465-1214
Fax: (410) 465-2057
Mailing address: 5920 Great Star Dr Unit 403, Clarksville, MD 21029-1362

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 15517 (MD)

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Registry record

NPI: 1003233156
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Mar 2014
Record last updated: 5 Nov 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.