Provider Demographics
NPI:1306404876
Name:YALIM, LAURA (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:YALIM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16405 E MONACO DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-4423
Mailing Address - Country:US
Mailing Address - Phone:480-276-2708
Mailing Address - Fax:
Practice Address - Street 1:81 W GUADALUPE RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3321
Practice Address - Country:US
Practice Address - Phone:480-400-8871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD010338122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist