Provider Demographics
NPI:1790791986
Name:MARKLEY, LAURA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:MARKLEY
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 1:67470 FERNBROOK RD
Mailing Address - Street 2:
Mailing Address - City:NEW PARIS
Mailing Address - State:IN
Mailing Address - Zip Code:46553-9183
Mailing Address - Country:US
Mailing Address - Phone:574-831-4477
Mailing Address - Fax:574-831-4488
Practice Address - Street 1:67470 FERNBROOK RD
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:IN
Practice Address - Zip Code:46553-9183
Practice Address - Country:US
Practice Address - Phone:574-831-4477
Practice Address - Fax:574-831-4488
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120099751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice