Provider Demographics
NPI:1922035674
Name:MCAULEY, LAURA BURLEY (DDS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BURLEY
Last Name:MCAULEY
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 1:6202 N 9TH AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8291
Mailing Address - Country:US
Mailing Address - Phone:850-505-9778
Mailing Address - Fax:850-505-9768
Practice Address - Street 1:6202 N 9TH AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8293
Practice Address - Country:US
Practice Address - Phone:850-505-9778
Practice Address - Fax:850-505-9768
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN153031223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry