Provider Demographics
NPI:1760599492
Name:BRANIGAN, LAURA (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:BRANIGAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD189811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice