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Organization

LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.

Active
Parent organization
DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, P.C.
Other names
Dental Proffesionals of Maryland, Gerald Amadzi P.C.
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, P.C.
Authorized official
TABATHA FORREST LEMKE (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization

Contact information

Practice address
13919 BALTIMORE AVE, LAUREL, MD 20707-5044
(301) 498-6511
Mailing address
1200 NETWORK CENTER DR, SUITE 2, EFFINGHAM, IL 62401
(217) 540-8946
(217) 540-8946

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
08/24/2017
Last updated
07/21/2022
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