Organization
LAUREL LAKES PEDIATRIC DENTISTRY, LLC
Active
Other names
Laurel Lakes Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ANTIONETTE C. WILSON DDS (OWNER)
(202) 276-0649
Entity
Organization
Contact information
Practice address
13964 BALTIMORE AVE, SUITE C6, LAUREL, MD 20707
(202) 276-0649
(631) 857-7860
Mailing address
401 CHURCH ST, SUITE 2210, NASHVILLE, TN 37219-2310
(615) 988-2627
(631) 857-7860
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
13970
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13970
DENTAL LICENSE
MD
Enumeration date
01/27/2017
Last updated
07/20/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us