Provider Demographics
NPI:1154433365
Name:DEPAOLA, LOUIS GEORGE (DDS MS)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:GEORGE
Last Name:DEPAOLA
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:3805 SHADY LANE
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21738-9503
Mailing Address - Country:US
Mailing Address - Phone:410-446-5724
Mailing Address - Fax:410-489-9055
Practice Address - Street 1:600 LIGHT STREET
Practice Address - Street 2:
Practice Address - City:BALTO
Practice Address - State:MD
Practice Address - Zip Code:21230-3856
Practice Address - Country:US
Practice Address - Phone:410-659-0900
Practice Address - Fax:410-659-0902
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD59001223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics