Provider Demographics
NPI:1336765650
Name:CABANISS, LAUREN BROOKE (DMD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:BROOKE
Last Name:CABANISS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SPRING PL
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-9168
Mailing Address - Country:US
Mailing Address - Phone:256-415-0158
Mailing Address - Fax:
Practice Address - Street 1:22727 AL-25
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:AL
Practice Address - Zip Code:35051
Practice Address - Country:US
Practice Address - Phone:205-669-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.0006774-C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice