Provider Demographics
NPI:1376780197
Name:MUHAMMAD, LAURA A W (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A W
Last Name:MUHAMMAD
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 1:4524 C ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-4372
Mailing Address - Country:US
Mailing Address - Phone:202-905-4430
Mailing Address - Fax:202-581-1231
Practice Address - Street 1:2401 CALVERT ST NW APT 106
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2655
Practice Address - Country:US
Practice Address - Phone:202-462-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN48461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice