Provider Demographics
NPI:1871554501
Name:ZOLFAGHARI, AMIR H (DDS)
Entity type:Individual
Prefix:DR
First Name:AMIR
Middle Name:H
Last Name:ZOLFAGHARI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 N SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2920
Mailing Address - Country:US
Mailing Address - Phone:301-527-7710
Mailing Address - Fax:301-527-1114
Practice Address - Street 1:104 N SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2920
Practice Address - Country:US
Practice Address - Phone:301-527-7710
Practice Address - Fax:301-527-1114
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12190122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist