Provider Demographics
NPI:1417009721
Name:HUYNH, LAURA T (DDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:T
Last Name:HUYNH
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 1:26 W PORTAL AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1342
Mailing Address - Country:US
Mailing Address - Phone:415-661-7779
Mailing Address - Fax:415-592-0137
Practice Address - Street 1:26 WEST PORTAL AVE.
Practice Address - Street 2:SUITE #4
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127
Practice Address - Country:US
Practice Address - Phone:415-661-7779
Practice Address - Fax:415-592-0137
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist