Provider Demographics
NPI:1588701189
Name:AJMAL, RIFFAT (DDS)
Entity type:Individual
Prefix:
First Name:RIFFAT
Middle Name:
Last Name:AJMAL
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 1:7756 ROTHERHAM DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1460
Mailing Address - Country:US
Mailing Address - Phone:301-520-8991
Mailing Address - Fax:410-480-1077
Practice Address - Street 1:10306 BALTIMORE NATIONAL PIKE # B
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2128
Practice Address - Country:US
Practice Address - Phone:410-480-3700
Practice Address - Fax:410-480-1077
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice