Provider Demographics
NPI:1578587143
Name:LAUGHLIN, KEVIN TROY (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:TROY
Last Name:LAUGHLIN
Suffix:
Gender:M
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 8239
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-0239
Mailing Address - Country:US
Mailing Address - Phone:409-755-4444
Mailing Address - Fax:409-755-3666
Practice Address - Street 1:120 COUNTRY LANE DR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-6802
Practice Address - Country:US
Practice Address - Phone:409-755-4444
Practice Address - Fax:409-755-3666
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX167811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice