Provider Demographics
NPI:1447466909
Name:LAUREN WILKINSON DDS PA
Entity type:Organization
Organization Name:LAUREN WILKINSON DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:W
Authorized Official - Last Name:SHEFRIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-986-6874
Mailing Address - Street 1:5015 SHELBOURNE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041
Mailing Address - Country:US
Mailing Address - Phone:770-888-5151
Mailing Address - Fax:
Practice Address - Street 1:21050 POINT PLACE #1105
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180
Practice Address - Country:US
Practice Address - Phone:305-986-6874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty