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Individual

LAURIE K MCCAULEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD PHD

Contact information

Practice address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-1562
(734) 763-3389
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-1562
(734) 763-3389

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2901016012
MI
1223P0300X
Periodontics
Primary
2901016012
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
195816298
BCBS OF MI MED SURGICAL
MI
01
D160120
BCBS OF MI DENTAL
MI
Enumeration date
03/14/2007
Last updated
06/17/2008
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