Provider Demographics
NPI:1730297599
Name:LAURA BRANIGAN DMD LLC
Entity Type:Organization
Organization Name:LAURA BRANIGAN DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-493-3446
Mailing Address - Street 1:901 W PARK AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-7271
Mailing Address - Country:US
Mailing Address - Phone:732-493-3446
Mailing Address - Fax:732-601-5131
Practice Address - Street 1:901 W PARK AVE
Practice Address - Street 2:SUITE C
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-7271
Practice Address - Country:US
Practice Address - Phone:732-493-3446
Practice Address - Fax:732-601-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD189811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty