Provider Demographics
NPI:1932372620
Name:LANHAM DENTAL SERVICES INC.
Entity Type:Organization
Organization Name:LANHAM DENTAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WILSON-WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-306-5195
Mailing Address - Street 1:9470 ANNAPOLIS RD
Mailing Address - Street 2:SUITE #109
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3025
Mailing Address - Country:US
Mailing Address - Phone:301-306-5195
Mailing Address - Fax:301-306-5197
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:SUITE #109
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:301-306-5195
Practice Address - Fax:301-306-5197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10597261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental