Provider Demographics
NPI:1033251483
Name:LAUDERT, SUZANNE SANDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:SANDRA
Last Name:LAUDERT
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 1:8200 EAST BELLEVIEW AVE
Mailing Address - Street 2:SUITE 460 EAST
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2828
Mailing Address - Country:US
Mailing Address - Phone:303-694-0587
Mailing Address - Fax:303-694-3645
Practice Address - Street 1:8200 EAST BELLEVIEW AVE
Practice Address - Street 2:SUITE 460 EAST
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2828
Practice Address - Country:US
Practice Address - Phone:303-694-0587
Practice Address - Fax:303-694-3645
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD5900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist