Healthcare Provider Details

I. General information

NPI: 1922022615
Provider Name (Legal Business Name): LAURA DAY BRASWELL D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/01/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 HOWELL MILL RD NW STE 311
ATLANTA GA
30327-4111
US

IV. Provider business mailing address

3280 HOWELL MILL RD NW STE 331
ATLANTA GA
30327-4109
US

V. Phone/Fax

Practice location:
  • Phone: 404-261-9593
  • Fax: 404-261-9409
Mailing address:
  • Phone: 404-261-9593
  • Fax: 404-261-9409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDN009901
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberGA9901
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: