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General NPI Number Information
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NPI Number | 1730852799
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Entity Type | Organization
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Legal Business Name | LAURA KEARNEY DDS PLLC
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Dates
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Enumeration Date | 07/27/2021
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 209 BLUE HERON DR
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City | YOUNGSVILLE
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State | NC
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Zip | 27596-7674
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Country | US
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Telephone | 252-230-6484
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Fax |
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Provider Business Mailing Address
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Address Line | 209 BLUE HERON DR
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City | YOUNGSVILLE
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State | NC
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Zip | 27596-7674
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Country | US
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Telephone | 252-230-6484
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. LAURA ANNE KEARNEY
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Credential | DDS
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Telephone | 252-230-6484
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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 |
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License Number State |
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