Dr. Laura Lynn Dameron, DMD
Dentist, General Practice in Canton, GA. Individual provider (NPI-1).
NPI number1790790103
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1790790103
- Entity type
- Individual (NPI-1)
- Name
- Dr. Laura Lynn Dameron
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 31, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 011695 | GA | Yes |
Practice location
6199 Hickory Flat HwySuite 130
Canton, GA 30115-7255
Phone 770-345-8646
Mailing address
6199 Hickory Flat HwySuite 130
Canton, GA 30115-7255
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