Ms. Lauryn Elizabeth Gresham
Dental Assistant
6323 N Fresno St Ste 101
Fresno
, California 93710-5282
Ms. Lauryn Elizabeth Gresham
Dental Assistant
6323 N Fresno St Ste 101
Fresno
, California 93710-5282
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About
Features
Specialties
- Dental Assistant
Languages spoken
- English
Location
First Address
- Ms. Lauryn Elizabeth Gresham
- 34697 Road 221 Wishon Ca 93669 P.o. Box 852
- North Fork Ca, CALIFORNIA
- Zip : 93643
- Phone :
Second Address
- Ms. Lauryn Elizabeth Gresham
- 6323 N Fresno St Ste 101
- Fresno, CA
- Zip : 93710-5282
- Phone : (559) 439-2307
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Is Ms. Lauryn Elizabeth Gresham a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 91009 | CA |
National Provider Identifier
| NPI | 1093289902 |
|---|---|
| Provider Name | Ms. Lauryn Elizabeth Gresham |
| First Address | North Fork Ca, CALIFORNIA 93643 |
| Second Address | Fresno, CA 93710-5282 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/01/2019 |
| Last Update Date | 14/01/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| D8733126 | NON MEDICARE (01) | CA |
| D8733126 | SELF (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.