Provider Demographics
NPI:1245554427
Name:LAURA A PARRA, DDS, PA
Entity type:Organization
Organization Name:LAURA A PARRA, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PARRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-383-7020
Mailing Address - Street 1:3400 CROASDAILE DR
Mailing Address - Street 2:SUITE 209
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6815
Mailing Address - Country:US
Mailing Address - Phone:919-383-7020
Mailing Address - Fax:919-383-3141
Practice Address - Street 1:3400 CROASDAILE DR
Practice Address - Street 2:SUITE 209
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6815
Practice Address - Country:US
Practice Address - Phone:919-383-7020
Practice Address - Fax:919-383-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5415261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8996636Medicaid
U63578Medicare UPIN