Provider Demographics
NPI:1760646871
Name:UDOUJ, LARA KAYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARA
Middle Name:KAYE
Last Name:UDOUJ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:300 S RODNEY PARHAM RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4747
Mailing Address - Country:US
Mailing Address - Phone:501-224-5548
Mailing Address - Fax:501-224-9278
Practice Address - Street 1:300 S RODNEY PARHAM RD
Practice Address - Street 2:SUITE 3
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-4747
Practice Address - Country:US
Practice Address - Phone:501-224-5548
Practice Address - Fax:501-224-9278
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARAR3672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist