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NPI Code Detail

MEDICARE: DR. LAURA COLLEEN MCDONALD D.D.S.

MEDICARE:  DR. LAURA COLLEEN MCDONALD  D.D.S.
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
11223G0001XGeneral Practice Dentistry32207TX

General Provider Information

NPI Number : 1831649862
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA COLLEEN MCDONALD D.D.S.
Provider Business Mailing Address
First Line : 3700 MCKINNEY AVE APT 359
Second Line :
City : DALLAS
State : TX
Zip : 75204-1693
Country : US
Telephone Number : 956-279-5360
Fax Number :
Provider Business Practice Location Address
First Line : 1315 W JEFFERSON BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75208-5324
Country : US
Telephone Number : 214-941-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2016
Last Update Date : 10/13/2016

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Directions to “ DR. LAURA COLLEEN MCDONALD D.D.S.” Practice Location

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