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Organization

LYNNE S BRODELL DDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LYNNE S BRODELL D.D.S. (OWNER)
(301) 729-0444
Entity
Organization

Contact information

Practice address
12600 WINCHESTER RD SW, LAVALE, MD 21502-6551
(301) 729-0444
(301) 729-0404
Mailing address
12600 WINCHESTER RD SW, LAVALE, MD 21502-6551
(301) 729-0444
(301) 729-0404

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13274
MD
1223G0001X
General Practice Dentistry
6993
MD
1223G0001X
General Practice Dentistry
Primary
9121
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
378654400
MD
Enumeration date
11/20/2006
Last updated
08/20/2008
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