Gormley, Laurie A

Gormley, Laurie A is an individual health care provider with primary practice located at 2701 Missouri Ave Suite C, Las Cruces NM 88011-5091. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Gormley, Laurie A can be contacted via phone (505) 522-8229.

Contact Information

Primary practice address
2701 Missouri Ave Suite C Las Cruces NM 88011-5091
Fax: (505) 522-8123
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DD1732 New Mexico

Profile Details

NPI number 1518958883
LBN Legal business name Gormley, Laurie A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518958883 NPPES
New Mexico MEDICAID 4342
New Mexico MEDICAID 00081595

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