Provider Demographics
NPI:1376228171
Name:THAMES, LAUREN RAE HERRING (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:RAE HERRING
Last Name:THAMES
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 1:106 JOSEY AVE
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-3131
Mailing Address - Country:US
Mailing Address - Phone:601-573-1203
Mailing Address - Fax:
Practice Address - Street 1:1171 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ACKERMAN
Practice Address - State:MS
Practice Address - Zip Code:39735-9049
Practice Address - Country:US
Practice Address - Phone:662-634-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4381-231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice