Provider Demographics
NPI:1902004062
Name:KAISER, LAURA ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANN
Last Name:KAISER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28331 S TAMIAMI TRL STE 13
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-3215
Mailing Address - Country:US
Mailing Address - Phone:239-949-8220
Mailing Address - Fax:239-948-7704
Practice Address - Street 1:28331 S TAMIAMI TRL STE 13
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-3215
Practice Address - Country:US
Practice Address - Phone:239-949-8220
Practice Address - Fax:239-948-7704
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0014872122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist