Provider Demographics
NPI:1104898261
Name:GRIER, LAURA L (DDS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:GRIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 E PLAZA DR
Mailing Address - Street 2:SUITE 1 & 2
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-8000
Mailing Address - Country:US
Mailing Address - Phone:704-799-2703
Mailing Address - Fax:
Practice Address - Street 1:128 E PLAZA DR
Practice Address - Street 2:SUITE 1 & 2
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-8000
Practice Address - Country:US
Practice Address - Phone:704-799-2703
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC64941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice