| Dr Michelle Latortue, DDS | |
|
5 N First St, Indian Head, MD 20640-1801 | |
| (813) 508-4563 | |
| Not Available |
| Full Name | Dr Michelle Latortue |
|---|---|
| Gender | Female |
| Speciality | Dentist - General Practice |
| Location | 5 N First St, Indian Head, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750803789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DEN1001899 (District Of Columbia) | Secondary |
| 1223G0001X | Dentist - General Practice | 16526 (Maryland) | Primary |
| Entity Name | Latortue Smiles |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124782990 PECOS PAC ID: 9032501622 Enrollment ID: O20220111000901 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michelle Latortue, DDS 3624 Brothers Pl Se, Washington, DC 20032-1523 Ph: (813) 508-4563 | Dr Michelle Latortue, DDS 5 N First St, Indian Head, MD 20640-1801 Ph: (813) 508-4563 |
Keith Lynn Mayberry, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1600 W Wilson Rd, Indian Head, MD 20640 Phone: 301-744-4601 | |
Dr. Alan I Lemberg, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1 North First St, Indian Head, MD 20540 Phone: 301-743-5252 | |
Dr. Dexter Arvange Woods, D.D.S Dentist Medicare: Not Enrolled in Medicare Practice Location: 158 Riverwatch Dr, Indian Head, MD 20640 Phone: 301-743-5210 | |
Dr. Chatchaval Pongsugree, DDS Dentist Medicare: Medicare Enrolled Practice Location: 4141 W Wilson Rd Bldg 1600, Indian Head, MD 20640 Phone: 301-744-4948 |