Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 58050 | CA |
NPI | 1073743852 |
---|---|
Provider Name | Dr. Caroline Anne Laurent |
First Address | Sonoma, CA 95476-6726 |
Second Address | Sonoma, CA 95476-6726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2009 |
Last Update Date | 15/07/2009 |