| Lakeside Smiles, Llc | |
|
7135 Minstrel Way Ste 101 Columbia MD 21045-5293 | |
| (443) 832-3305 | |
| Not Available |
| Full Name | Lakeside Smiles, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7135 Minstrel Way Ste 101, Columbia, Maryland |
| Authorized Official Name and Position | Kathy Dipasquale Kim (OWNER, DENTIST) |
| Authorized Official Contact | 4439799155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Smiles, Llc 11716 Pindell Chase Dr Fulton MD 20759-9704 Ph: (703) 943-8360 | Lakeside Smiles, Llc 7135 Minstrel Way Ste 101 Columbia MD 21045-5293 Ph: (443) 832-3305 |
| NPI Number | 1841750965 |
|---|---|
| Provider Enumeration Date | 03/24/2019 |
| Last Update Date | 10/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841750965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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