Provider Demographics
NPI:1346370723
Name:MILLS, LAURA JANE (DDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JANE
Last Name:MILLS
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 1:38 LENOX POINTE NE # A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3169
Mailing Address - Country:US
Mailing Address - Phone:404-262-9600
Mailing Address - Fax:404-233-9470
Practice Address - Street 1:38 LENOX POINTE NE # A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3169
Practice Address - Country:US
Practice Address - Phone:404-262-9600
Practice Address - Fax:404-233-9470
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA99531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice