Boroumand Rad, Bahar
Boroumand Rad, Bahar is an individual health care provider with primary practice located at 12165 Elm St , Princess Anne MD 21853-1358. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Boroumand Rad, Bahar can be contacted via phone (410) 651-5151.Contact Information
Primary practice address
12165 Elm St
Princess Anne MD 21853-1358
Phone: (410) 651-5151
Fax: (410) 651-5151
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | LL928 | Maryland |
Profile Details
| NPI number | 1760226591 |
|---|---|
| LBN Legal business name | Boroumand Rad, Bahar |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2024 |
| Last updated | Jun 25th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760226591 | NPPES |
| Maryland | MEDICAID | 119591300 |
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