MEDICARE: LAURA J. MCLAUGHLIN, DMD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3930	SC

General Provider Information

NPI Number	:	1275764326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA J. MCLAUGHLIN, DMD, LLC

Provider Business Mailing Address
First Line	:	1342 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2337
Country	:	US
Telephone Number	:	803-980-7645
Fax Number	:	803-980-7655

Provider Business Practice Location Address
First Line	:	1342 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2337
Country	:	US
Telephone Number	:	803-980-7645
Fax Number	:	803-980-7655

Authorized Official
Title or Position	:	DENTIST
Name	:	LAURA J MCLAUGHLIN
Credential	:	D.M.D.
Telephone Number	:	803-980-7645

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	08/06/2009

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