MEDICARE: DR. LAURIER LYNN MCCRAVY 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	DN9281	FL

General Provider Information

NPI Number	:	1821078718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURIER LYNN MCCRAVY DMD

Provider Business Mailing Address
First Line	:	515 WEST SIXTH STREET
Second Line	:	DUVAL CENTRAL HEALTH PLAZA
City	:	JACKSONVILLE
State	:	FL
Zip	:	32206-4324
Country	:	US
Telephone Number	:	904-253-1986
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 WEST SIXTH STREET
Second Line	:	DUVAL CENTRAL HEALTH PLAZA
City	:	JACKSONVILLE
State	:	FL
Zip	:	32206-4324
Country	:	US
Telephone Number	:	904-253-1986
Fax Number	:

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	02/27/2023

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