Provider Demographics
NPI:1568026458
Name:CAROLINE LAROSILIERE DDS AND ASSOCIATES
Entity Type:Organization
Organization Name:CAROLINE LAROSILIERE DDS AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:LAROSILIERE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-773-7703
Mailing Address - Street 1:1401 MERCANTILE LN STE 102
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4306
Mailing Address - Country:US
Mailing Address - Phone:301-773-7703
Mailing Address - Fax:301-773-7708
Practice Address - Street 1:1401 MERCANTILE LN STE 102
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4306
Practice Address - Country:US
Practice Address - Phone:301-773-7703
Practice Address - Fax:301-773-7708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty