| Lakeside Dental | |
|
100 Lakeforest Blvd Suite 620 Gaithersburg MD 20877-2609 | |
| (301) 990-7778 | |
| Not Available |
| Full Name | Lakeside Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Lakeforest Blvd, Gaithersburg, Maryland |
| Authorized Official Name and Position | Robert J Mauri (PRACTICE MANAGER) |
| Authorized Official Contact | 3019907778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Dental 100 Lakeforest Blvd Suite 620 Gaithersburg MD 20877-2609 Ph: (301) 990-7778 | Lakeside Dental 100 Lakeforest Blvd Suite 620 Gaithersburg MD 20877-2609 Ph: (301) 990-7778 |
| NPI Number | 1932392891 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 08/23/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932392891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | MD7735 (Maryland) | Primary |
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