| NPI | 1053715268 |
|---|---|
| Doing Business As | LAUREL LAKES COSMETIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MICHELLE STOVALL Pediatric Dentistry 240-441-2193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |