Provider Demographics
NPI:1316473432
Name:KALER, LAURA CASTILLO (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CASTILLO
Last Name:KALER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3733 JEFFERSON PIKE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:MD
Mailing Address - Zip Code:21755
Mailing Address - Country:US
Mailing Address - Phone:301-834-8804
Mailing Address - Fax:301-371-0232
Practice Address - Street 1:3733 JEFFERSON PIKE
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:MD
Practice Address - Zip Code:21755
Practice Address - Country:US
Practice Address - Phone:301-834-8804
Practice Address - Fax:301-371-0232
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD 08569122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist