Provider Demographics
NPI:1427400100
Name:ROWAN, LAURA CHAN (DDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:CHAN
Last Name:ROWAN
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 1:2 HAWTHORNE PL
Mailing Address - Street 2:APT. 2H
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2343
Mailing Address - Country:US
Mailing Address - Phone:626-200-6261
Mailing Address - Fax:
Practice Address - Street 1:2 HAWTHORNE PL
Practice Address - Street 2:APT. 2H
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2343
Practice Address - Country:US
Practice Address - Phone:626-200-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18573011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice