Provider Demographics
NPI:1407300502
Name:COFFMAN, LAUREN EMILY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:EMILY
Last Name:COFFMAN
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 1:350 WESTPARK WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3965
Mailing Address - Country:US
Mailing Address - Phone:817-283-5376
Mailing Address - Fax:
Practice Address - Street 1:350 WESTPARK WAY STE 200
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3965
Practice Address - Country:US
Practice Address - Phone:817-283-5376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2018-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32087122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist