Provider Demographics
NPI:1700907847
Name:RAIMONDO, CIBELE LIMA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CIBELE
Middle Name:LIMA
Last Name:RAIMONDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7204 CASULAS CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5381
Mailing Address - Country:US
Mailing Address - Phone:301-483-9574
Mailing Address - Fax:
Practice Address - Street 1:621 RIDGELY AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1081
Practice Address - Country:US
Practice Address - Phone:410-224-2660
Practice Address - Fax:410-224-8564
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD129321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice