Provider Demographics
NPI:1982905469
Name:HASTINGS, LAURA D (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:D
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 GRELOT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3606
Mailing Address - Country:US
Mailing Address - Phone:251-343-3807
Mailing Address - Fax:251-343-4159
Practice Address - Street 1:5920 GRELOT RD
Practice Address - Street 2:SUITE A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-3606
Practice Address - Country:US
Practice Address - Phone:251-343-3807
Practice Address - Fax:251-343-4159
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice