Provider Demographics
NPI:1720473184
Name:NAPODANO, LARA ASHLYN HOLLAND (DMD)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:ASHLYN HOLLAND
Last Name:NAPODANO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:ASHLYN
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1000 BLYTHE BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5812
Mailing Address - Country:US
Mailing Address - Phone:704-355-2165
Mailing Address - Fax:704-355-8856
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-355-2165
Practice Address - Fax:704-355-8856
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13801853122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist