Provider Demographics
NPI:1992052377
Name:GOLDEN, LAUREN NICOLE (DDS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:GOLDEN
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 1:14626 FM 2100 RD STE A
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-9160
Mailing Address - Country:US
Mailing Address - Phone:281-328-3525
Mailing Address - Fax:
Practice Address - Street 1:14626 FM 2100 RD STE A
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-9160
Practice Address - Country:US
Practice Address - Phone:281-328-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX282831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice