Individual
DR. LAURA C DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
102 CRESCENT W, GRIFFIN, GA 30224-4862
(770) 412-8636
(770) 412-7019
Mailing address
102 CRESCENT W, GRIFFIN, GA 30224-4862
(770) 412-8636
(770) 412-7019
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00345078A
—
GA
Enumeration date
09/28/2006
Last updated
07/08/2007
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