Provider Demographics
NPI:1811125586
Name:TAWIL, LAURA DAVIES-LUDLOW (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:DAVIES-LUDLOW
Last Name:TAWIL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ELIZABETH
Other - Last Name:DAVIES-LUDLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:79 FALLING SPRINGS DR.
Mailing Address - Street 2:SUITE #110
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516
Mailing Address - Country:US
Mailing Address - Phone:919-636-9717
Mailing Address - Fax:
Practice Address - Street 1:79 FALLING SPRINGS DR.
Practice Address - Street 2:SUITE #110
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516
Practice Address - Country:US
Practice Address - Phone:919-636-9717
Practice Address - Fax:919-869-1495
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NCNC88101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004011136Medicaid