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General NPI Number Information
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NPI Number | 1316209570
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Entity Type | Individual
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Provider Name | LAUREN PRICE D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 31W742 PERCHERON LN # 1288
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City | WAYNE
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State | IL
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Zip | 60184-2338
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Country | US
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Telephone | 480-406-8945
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Fax |
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Provider Business Mailing Address
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Address Line | 31W742 PERCHERON LN # 1288
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City | WAYNE
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State | IL
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Zip | 60184-2338
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Country | US
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Telephone | 480-406-8945
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 1855989
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019029596
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License Number State | IL
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