Provider Demographics
NPI:1477762094
Name:PIERCE, LAURA DRAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:DRAY
Last Name:PIERCE
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 1:13035 LEE JACKSON MEMORIAL HWY STE A
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2039
Mailing Address - Country:US
Mailing Address - Phone:703-968-6956
Mailing Address - Fax:703-968-8268
Practice Address - Street 1:13035 LEE JACKSON MEMORIAL HWY STE A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2039
Practice Address - Country:US
Practice Address - Phone:703-968-6956
Practice Address - Fax:703-968-8268
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412952122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist