Organization
LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.
Active
Parent organization
LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.
Other names
Olde Town Laurel Dental, Dental Professionals of Maryland, Gerald Awadzi, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
535 MAIN STREET, SUITE 113, LAUREL, MD 20707-4335
(301) 490-0044
(301) 497-1900
Mailing address
535 MAIN ST STE 113, LAUREL, MD 20707-4335
(301) 490-0044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10680
MD
Other
Enumeration date
10/02/2006
Last updated
06/07/2021
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