Provider Demographics
NPI:1720348832
Name:STYRON, LAURA (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:STYRON
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 1:1370 TAYLOR ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5508
Mailing Address - Country:US
Mailing Address - Phone:405-517-2382
Mailing Address - Fax:
Practice Address - Street 1:1120 19TH ST NW STE 400
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3661
Practice Address - Country:US
Practice Address - Phone:202-833-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK63861223G0001X
CO2024551223G0001X
DCDEN10017581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice