Provider Demographics
NPI:1881970184
Name:GREER, LAURA M (RDH, BS)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:GREER
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 NORTHWIND AVE # B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4141
Mailing Address - Country:US
Mailing Address - Phone:907-306-5695
Mailing Address - Fax:
Practice Address - Street 1:8150 NORTHWIND AVE # B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-4141
Practice Address - Country:US
Practice Address - Phone:907-306-5695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2063124Q00000X
KY3825124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist