Organization
R3 DENTAL GROUP LLC
Active
Other names
Lakeside Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ALIREZA RAJAEI (OWNER)
(301) 438-1200
Entity
Organization
Contact information
Practice address
100 LAKEFOREST BLVD STE 620, GAITHERSBURG, MD 20877-6203
(301) 990-7778
Mailing address
100 LAKEFOREST BLVD STE 620, GAITHERSBURG, MD 20877-6203
(301) 990-7778
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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