Provider Demographics
NPI:1396746251
Name:LAUGHREY, NATHAN CHARLES (DMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:CHARLES
Last Name:LAUGHREY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:SUITE 108 AGH DEPT OF DENTISTRY
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-6001
Mailing Address - Fax:412-359-4063
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:SUITE 108 AGH DEPT OF DENTISTRY
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-6001
Practice Address - Fax:412-359-4063
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030849L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018382580004Medicaid
PA0018382580004Medicaid
PA072789PV2Medicare PIN