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Individual
DR. LAUREN GRAHAM BOURELL
Active
Individual
DR. LAUREN GRAHAM BOURELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
30.024410
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
30.024410
OH
Other
Enumeration date
04/13/2008
Last updated
08/01/2019
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