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
Phone: (505) 522-8229
Fax: (505) 522-8123
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518958883 | NPPES |
| New Mexico | MEDICAID | 4342 | |
| New Mexico | MEDICAID | 00081595 |
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