Provider Demographics
NPI:1194043349
Name:BACHARA, LAURA ROSARIO (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ROSARIO
Last Name:BACHARA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9921 JOE LEACH RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603
Mailing Address - Country:US
Mailing Address - Phone:919-710-7383
Mailing Address - Fax:
Practice Address - Street 1:9921 JOE LEACH RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-9061
Practice Address - Country:US
Practice Address - Phone:919-710-7383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC89251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice