Provider Demographics
NPI:1942529128
Name:JUNTGEN, LAURA MICHELLE (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MICHELLE
Last Name:JUNTGEN
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13430 NORTH MERIDIAN STREET
Mailing Address - Street 2:SUITE 165
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-846-5893
Mailing Address - Fax:317-484-6587
Practice Address - Street 1:13430 NORTH MERIDIAN STREET
Practice Address - Street 2:SUITE 165
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-846-5893
Practice Address - Fax:317-484-6587
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011451A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist