Provider Demographics
NPI:1699936021
Name:DRAGONIR, LORRAINE LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:LEE
Last Name:DRAGONIR
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 1:3529 SPLIT RAIL LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3832
Mailing Address - Country:US
Mailing Address - Phone:410-245-2840
Mailing Address - Fax:410-245-2840
Practice Address - Street 1:5565 STERRETT PL
Practice Address - Street 2:SUITE 121
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2665
Practice Address - Country:US
Practice Address - Phone:410-245-2840
Practice Address - Fax:410-245-2840
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2016-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist