Provider Demographics
NPI:1881959898
Name:DAVIES, LAURA E (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:E
Last Name:DAVIES
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 1:2800 JACKSON BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-1504
Mailing Address - Country:US
Mailing Address - Phone:605-348-0831
Mailing Address - Fax:605-348-0602
Practice Address - Street 1:2800 JACKSON BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-1504
Practice Address - Country:US
Practice Address - Phone:605-348-0831
Practice Address - Fax:605-348-0602
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD09911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice