=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427864131
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAUREN ALOIA DMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2024
-----------------------------------------------------
Last Update Date | 12/06/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3185 W HOUGHTON LAKE DR
-----------------------------------------------------
City | HOUGHTON LAKE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48629-8242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-366-9621
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19W113 AVENUE NORMANDY S
-----------------------------------------------------
City | OAK BROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60523-7604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-720-9925
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 2901602396
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------