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General NPI Number Information
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NPI Number | 1821494238
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Entity Type | Organization
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Legal Business Name | THE DENTAL INSTITUTE
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 4330 E WEST HWY STE 316
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City | BETHESDA
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State | MD
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Zip | 20814-4408
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Country | US
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Telephone | 301-654-7808
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Fax | 301-654-3177
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Provider Business Mailing Address
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Address Line | 4330 E WEST HWY STE 316
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City | BETHESDA
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State | MD
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Zip | 20814-4408
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Country | US
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Telephone | 301-654-7808
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Fax | 301-654-3177
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. WILLIAM ALBERTO LANZA
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Credential | DDS
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Telephone | 301-654-7808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 14205
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License Number State | MD
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