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Organization

LAUREL PEDIATRIC DENTISTRY

Active
Other names
Laurel Lakes Cosmetic Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHELLE STOVALL DDS (PEDIATRIC DENTISTRY)
(240) 441-2193
Entity
Organization

Contact information

Practice address
13916 BALTIMORE AVE, LAUREL, MD 20707-5009
(301) 498-6511
Mailing address
13916 BALTIMORE AVE, LAUREL, MD 20707-5009
(301) 498-6511

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
10/17/2014
Last updated
10/17/2014
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