Provider Demographics
NPI:1295401768
Name:SEDLER, LAUREN W (RDH BS)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:W
Last Name:SEDLER
Suffix:
Gender:F
Credentials:RDH BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 PULASKI HWY STE 107
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3626
Mailing Address - Country:US
Mailing Address - Phone:410-679-4500
Mailing Address - Fax:
Practice Address - Street 1:413 PULASKI HWY STE 107
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3626
Practice Address - Country:US
Practice Address - Phone:410-679-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5890124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist