MEDICARE: THE DENTAL INSTITUTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	14205	MD

General Provider Information

NPI Number	:	1821494238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DENTAL INSTITUTE

Provider Business Mailing Address
First Line	:	4330 E WEST HWY STE 316
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-4408
Country	:	US
Telephone Number	:	301-654-7808
Fax Number	:	301-654-3177

Provider Business Practice Location Address
First Line	:	4330 E WEST HWY STE 316
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-4408
Country	:	US
Telephone Number	:	301-654-7808
Fax Number	:	301-654-3177

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. WILLIAM ALBERTO LANZA
Credential	:	DDS
Telephone Number	:	301-654-7808

Provider Enumeration Date	:	11/12/2014
Last Update Date	:	11/12/2014

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Directions to “THE DENTAL INSTITUTE ” Practice Location

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