Provider Demographics
NPI:1396023461
Name:PEARCE, LAUREN MELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MELL
Last Name:PEARCE
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 1:2607 S SOUTHEAST BLVD STE B180
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7625
Mailing Address - Country:US
Mailing Address - Phone:440-320-7050
Mailing Address - Fax:
Practice Address - Street 1:2607 S SOUTHEAST BLVD STE B180
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7625
Practice Address - Country:US
Practice Address - Phone:509-381-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-23
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL018-001815122300000X
WADE609704121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentist