Provider Demographics
NPI:1396167128
Name:PARKMAN, LAURA SPRAGENS (DMD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:SPRAGENS
Last Name:PARKMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:WELLS
Other - Last Name:SPRAGENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2201 J L TODD DR
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-5064
Mailing Address - Country:US
Mailing Address - Phone:706-235-6011
Mailing Address - Fax:
Practice Address - Street 1:2201 J L TODD DR
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-5064
Practice Address - Country:US
Practice Address - Phone:706-235-6011
Practice Address - Fax:706-235-6352
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014761122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist