Individual
DR. LAURA ANN BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
901 3RD ST, COLUMBUS, IN 47201-6816
(812) 373-9912
(812) 373-9920
Mailing address
901 3RD ST, COLUMBUS, IN 47201-6816
(812) 373-9912
(812) 373-9920
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010438A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200387920A
—
IN
Enumeration date
11/16/2006
Last updated
05/21/2008
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