Doctor Name: | LAURA SUSANA RADESCA |
NPI Number: | 1184691263 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DDS |
License Number: | 11582 |
Business Practice Address: | 2880 Dunkirk Way Suite 103 Dunkirk, MD - 20754 |
Business Phone Number: | 3018558888 |
Business Fax Number: | 4102577676 |
Mailing Address: | 1721 Justin Dr, GAMBRILLS |
State: | MD |
Postal Code: | 21114 |
Phone Number: | 4104511879 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 11582 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |