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General NPI Number Information
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NPI Number | 1346778412
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Entity Type | Individual
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Provider Name | LAURA KNOWLES DMD
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Gender | Female
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 06/01/2017
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Provider Practice Location Address
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Address Line | 4126 INDEPENDENT DR
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City | MARIANNA
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State | FL
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Zip | 32448-4023
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Country | US
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Telephone | 850-394-4964
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Fax | 850-394-4907
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Provider Business Mailing Address
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Address Line | 2600 SW WILLISTON RD APT 724
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City | GAINESVILLE
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State | FL
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Zip | 32608-3949
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Country | US
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Telephone | 850-591-5225
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN22620
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License Number State | FL
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