Provider Demographics
NPI:1558381152
Name:LAURENCE J.FIELDS,DDS & DAVID H. FROME,DDS,PA
Entity Type:Organization
Organization Name:LAURENCE J.FIELDS,DDS & DAVID H. FROME,DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:FROME
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-869-2500
Mailing Address - Street 1:8 RUSSELL AVENUE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2962
Mailing Address - Country:US
Mailing Address - Phone:301-869-2500
Mailing Address - Fax:301-926-7655
Practice Address - Street 1:8 RUSSELL AVENUE
Practice Address - Street 2:SUITE 104
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2962
Practice Address - Country:US
Practice Address - Phone:301-869-2500
Practice Address - Fax:301-926-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center