Individual
LAURA ST. BERNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
440 S PICKETT ST, ALEXANDRIA, VA 22304-4706
(571) 413-0833
(571) 413-0834
Mailing address
7019 WOODSTREAM LN, LANHAM, MD 20706-2141
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
17077
MD
Other
Enumeration date
01/13/2021
Last updated
11/28/2022
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