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General NPI Number Information
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NPI Number | 1225778764
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Entity Type | Organization
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Legal Business Name | NATIONAL ORTHODONTIC AND PEDIATRIC DENTISTRY ASSOCIATES CORP
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 3863 ALABAMA AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20020-1001
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Country | US
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Telephone | 301-367-8051
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Fax |
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Provider Business Mailing Address
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Address Line | 6200 GOLD YARROW LN
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-4010
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Country | US
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Telephone | 301-367-8051
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICK LAROSILIERE
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Credential | DDS
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Telephone | 301-367-8051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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