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General NPI Number Information
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NPI Number | 1841747078
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Entity Type | Organization
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Legal Business Name | LAUREL SMILES DENTAL CARE, LLC
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 14440 CHERRY LANE CT SUITE 209
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City | LAUREL
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State | MD
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Zip | 20707-4946
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Country | US
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Telephone | 301-490-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 14440 CHERRY LANE CT SUITE 209
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City | LAUREL
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State | MD
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Zip | 20707-4946
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Country | US
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Telephone | 301-490-7007
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAHIL GOYAL
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Credential | D.M.D
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Telephone | 410-730-6020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14250
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License Number State | MD
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