Healthcare Provider Details

I. General information

NPI: 1477933117
Provider Name (Legal Business Name): LAUREN KATZ MCKAY D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 BLUE RIDGE RD STE 310
RALEIGH NC
27607-6475
US

IV. Provider business mailing address

1209 WELDON PL
RALEIGH NC
27608-1954
US

V. Phone/Fax

Practice location:
  • Phone: 919-510-4959
  • Fax:
Mailing address:
  • Phone: 704-491-7627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number10018
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: