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General NPI Number Information
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NPI Number | 1134477250
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Entity Type | Organization
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Legal Business Name | ERIC J. LAVID, DDS, LLC
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Dates
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Enumeration Date | 08/21/2012
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 613 W CONWAY ST STE 101
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City | RAYMORE
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State | MO
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Zip | 64083-7301
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Country | US
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Telephone | 816-331-1144
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Fax | 816-322-2271
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Provider Business Mailing Address
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Address Line | 613 W CONWAY ST STE 101
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City | RAYMORE
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State | MO
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Zip | 64083-7301
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Country | US
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Telephone | 816-331-1144
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Fax | 816-322-2271
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JOY LAVID
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Credential | DDS
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Telephone | 816-331-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 016137
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 016088
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License Number State | MO
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