Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 3700 | MD |
NPI | 1053337303 |
---|---|
Provider Name | Dr. Lisa Demarco |
First Address | Silver Spring, MD 20904-2633 |
Second Address | Silver Spring, MD 20904-2633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |