Provider Demographics
NPI:1336775501
Name:ACUNA- VINLUAN, LAURA M (DDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:ACUNA- VINLUAN
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 1:198 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2935
Mailing Address - Country:US
Mailing Address - Phone:914-282-5544
Mailing Address - Fax:
Practice Address - Street 1:100 GREYROCK PL STE 116
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-3113
Practice Address - Country:US
Practice Address - Phone:203-348-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13017122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program