Provider Demographics
NPI:1255354056
Name:LAURENT, BARRY DUANE (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:DUANE
Last Name:LAURENT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8292 OLD COURTHOUSE RD STE B
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3864
Mailing Address - Country:US
Mailing Address - Phone:703-893-1603
Mailing Address - Fax:703-893-0200
Practice Address - Street 1:8292 OLD COURTHOUSE RD STE B
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3864
Practice Address - Country:US
Practice Address - Phone:703-893-1603
Practice Address - Fax:703-893-0200
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010059941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice