Provider Demographics
NPI:1457767220
Name:SMITH, LAURA EUGENIA (DDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:EUGENIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:PORRAS
Other - Last Name:ALONSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:500 JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2040
Mailing Address - Country:US
Mailing Address - Phone:504-330-0253
Mailing Address - Fax:
Practice Address - Street 1:1414 OLD SPANISH TRL
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-5022
Practice Address - Country:US
Practice Address - Phone:504-330-0253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA68021223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty