MEDICARE: DR. LAURA A. W. MUHAMMAD D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DEN4846	DC

General Provider Information

NPI Number	:	1376780197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA A. W. MUHAMMAD D.D.S.

Provider Business Mailing Address
First Line	:	4524 C ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-4372
Country	:	US
Telephone Number	:	202-905-4430
Fax Number	:	202-581-1231

Provider Business Practice Location Address
First Line	:	2401 CALVERT ST NW APT 106
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2655
Country	:	US
Telephone Number	:	202-462-7676
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	11/19/2010

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