| Decker & Lavine, Dds, Pa | |
|
14333 Laurel Bowie Rd Suite 201 Laurel MD 20708-1126 | |
| (301) 776-3066 | |
| (301) 776-3115 |
| Full Name | Decker & Lavine, Dds, Pa |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 14333 Laurel Bowie Rd, Laurel, Maryland |
| Authorized Official Name and Position | David Lavine (OWNER) |
| Authorized Official Contact | 3017763066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Decker & Lavine, Dds, Pa 14333 Laurel Bowie Rd Suite 201 Laurel MD 20708-1126 Ph: (301) 776-3066 | Decker & Lavine, Dds, Pa 14333 Laurel Bowie Rd Suite 201 Laurel MD 20708-1126 Ph: (301) 776-3066 |
| NPI Number | 1316236813 |
|---|---|
| Provider Enumeration Date | 04/05/2011 |
| Last Update Date | 04/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316236813 | NPI | - | NPPES |
| 950724800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 11153 (Maryland) | Primary |
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