Provider Demographics
NPI:1073743852
Name:LAURENT, CAROLINE ANNE (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:ANNE
Last Name:LAURENT
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6826
Mailing Address - Country:US
Mailing Address - Phone:707-938-5255
Mailing Address - Fax:
Practice Address - Street 1:357 PERKINS ST
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6826
Practice Address - Country:US
Practice Address - Phone:707-938-5255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA580501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics