MEDICARE: DR. LAURENT PILON DMD

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	11081	NC

General Provider Information

NPI Number	:	1568956084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURENT PILON DMD

Provider Business Mailing Address
First Line	:	4418 CRYSTAL BREEZE ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614-8682
Country	:	US
Telephone Number	:	919-559-7024
Fax Number	:

Provider Business Practice Location Address
First Line	:	2741 CAMPUS WALK AVE BLDG 300
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-8878
Country	:	US
Telephone Number	:	919-908-8386
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2018
Last Update Date	:	06/18/2018

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