Provider Demographics
NPI:1346461936
Name:LAURAIN, ALAN R JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:LAURAIN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 MURFREESBORO RD.
Mailing Address - Street 2:STE. 201
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013
Mailing Address - Country:US
Mailing Address - Phone:615-367-0544
Mailing Address - Fax:615-399-4451
Practice Address - Street 1:2711 MURFREESBORO RD.
Practice Address - Street 2:STE. 201
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013
Practice Address - Country:US
Practice Address - Phone:615-367-0544
Practice Address - Fax:615-399-4451
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TND.S.3583122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist