Provider Demographics
NPI:1447032206
Name:RATCLIFE, LAURA LYNN
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:RATCLIFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 CABOT BLVD W STE 100
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1833
Mailing Address - Country:US
Mailing Address - Phone:267-297-2565
Mailing Address - Fax:
Practice Address - Street 1:2260 CABOT BLVD W STE 100
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1833
Practice Address - Country:US
Practice Address - Phone:267-297-2565
Practice Address - Fax:267-946-8918
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH012442L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist