MEDICARE: LAROSILIERE AND ASSOCIATES DENTAL CARE, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1223P0221X	Pediatric Dentistry
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
3	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1194977942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAROSILIERE AND ASSOCIATES DENTAL CARE, PA

Provider Business Mailing Address
First Line	:	5805 SILVER HILL RD
Second Line	:	# G
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-1168
Country	:	US
Telephone Number	:	301-568-8444
Fax Number	:

Provider Business Practice Location Address
First Line	:	5805 SILVER HILL RD
Second Line	:	# G
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-1168
Country	:	US
Telephone Number	:	301-568-8444
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PATRICK LAROSILIERE
Credential	:	DDS
Telephone Number	:	301-568-8444

Provider Enumeration Date	:	10/10/2008
Last Update Date	:	05/21/2019

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