Provider Demographics
NPI:1538489281
Name:DOUNA, LAURA O'NEILL (DDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:O'NEILL
Last Name:DOUNA
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:PO BOX 6429
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469-0429
Mailing Address - Country:US
Mailing Address - Phone:910-579-6999
Mailing Address - Fax:910-579-6977
Practice Address - Street 1:5950 BEACH DR SW
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-5246
Practice Address - Country:US
Practice Address - Phone:910-579-6999
Practice Address - Fax:910-579-6977
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC89551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5919515Medicaid