Provider Demographics
NPI:1841013497
Name:LAURA BETH HAYMORE, DDS, MPH, PLLC
Entity type:Organization
Organization Name:LAURA BETH HAYMORE, DDS, MPH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:HAYMORE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MPH, PLLC
Authorized Official - Phone:336-226-8406
Mailing Address - Street 1:1682 WESTBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9700
Mailing Address - Country:US
Mailing Address - Phone:336-226-8406
Mailing Address - Fax:
Practice Address - Street 1:1682 WESTBROOK AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-9700
Practice Address - Country:US
Practice Address - Phone:336-226-8406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental