Provider Demographics
NPI:1821078718
Name:MCCRAVY, LAURIER LYNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAURIER
Middle Name:LYNN
Last Name:MCCRAVY
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 1:515 WEST SIXTH STREET
Mailing Address - Street 2:DUVAL CENTRAL HEALTH PLAZA
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-4324
Mailing Address - Country:US
Mailing Address - Phone:904-253-1986
Mailing Address - Fax:
Practice Address - Street 1:515 WEST SIXTH STREET
Practice Address - Street 2:DUVAL CENTRAL HEALTH PLAZA
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-4324
Practice Address - Country:US
Practice Address - Phone:904-253-1986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN92811223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice