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General NPI Number Information
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NPI Number | 1831392380
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Entity Type | Individual
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Provider Name | LAUREN MOORE LAIRD DMD
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 801 UNIVERSITY BLVD S STE B
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City | MOBILE
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State | AL
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Zip | 36609-2923
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Country | US
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Telephone | 251-343-2170
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 JONATHAN CT
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City | MOBILE
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State | AL
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Zip | 36695-4470
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Country | US
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Telephone | 251-605-1587
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 5439
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License Number State | AL
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