MEDICARE: LAUREN ANN PARKER DDS

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	DN011065	GA
2	1223G0001X	General Practice Dentistry	DEN4973	DC

General Provider Information

NPI Number	:	1710094438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ANN PARKER DDS

Provider Business Mailing Address
First Line	:	201 W 8TH ST
Second Line	:	SUITE 810
City	:	PUEBLO
State	:	CO
Zip	:	81003-3038
Country	:	US
Telephone Number	:	719-562-4447
Fax Number	:

Provider Business Practice Location Address
First Line	:	3050 MARTIN LUTHER KING JR DR SW
Second Line	:	SUITE A
City	:	ATLANTA
State	:	GA
Zip	:	30311-1500
Country	:	US
Telephone Number	:	404-696-3163
Fax Number	:

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	12/29/2010

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