Provider Demographics
NPI:1528295268
Name:JOUFLAS, LAURA ANN (RDHAP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:JOUFLAS
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5819 W AVENUE K2
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-5650
Mailing Address - Country:US
Mailing Address - Phone:661-406-1315
Mailing Address - Fax:
Practice Address - Street 1:5819 W AVENUE K2
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-5650
Practice Address - Country:US
Practice Address - Phone:661-406-1315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-21
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP 248124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist