Provider Demographics
NPI:1447558739
Name:CAROLINE LAROSILIERE DDS AND ASSOCIATES
Entity Type:Organization
Organization Name:CAROLINE LAROSILIERE DDS AND ASSOCIATES
Other - Org Name:SMILES PEDIATRIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROSILIERE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-805-5437
Mailing Address - Street 1:9811 GREENBELT RD STE 208
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2219
Mailing Address - Country:US
Mailing Address - Phone:301-552-3807
Mailing Address - Fax:301-552-3809
Practice Address - Street 1:9811 GREENBELT RD STE 208
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-552-3807
Practice Address - Fax:301-552-3809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD123781223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9179229Medicaid