Provider Demographics
NPI:1134379316
Name:CRAIGHEAD, LAURA ASHLEY (DMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ASHLEY
Last Name:CRAIGHEAD
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 1:2611 HEARTLAND GREENS PT
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1588
Mailing Address - Country:US
Mailing Address - Phone:270-993-4377
Mailing Address - Fax:270-831-9749
Practice Address - Street 1:2660 S GREEN ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-4623
Practice Address - Country:US
Practice Address - Phone:270-831-9708
Practice Address - Fax:270-831-9749
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist