Provider Demographics
NPI:1043970684
Name:MYORTHOS MARYLAND ORTHODONTICS-LABBE PC
Entity Type:Organization
Organization Name:MYORTHOS MARYLAND ORTHODONTICS-LABBE PC
Other - Org Name:THABET ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LONABOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-665-7241
Mailing Address - Street 1:131 DARTMOUTH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5297
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20680 SENECA MEADOWS PKWY STE 207
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7029
Practice Address - Country:US
Practice Address - Phone:301-349-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MYORTHOS MARYLAND ORTHODONTICS-LABBE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-22
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty