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General NPI Number Information
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NPI Number | 1396283289
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Entity Type | Individual
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Provider Name | THOMAS LAUER
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Gender | Male
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 12700 SHERMAN WAY
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-5031
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Country | US
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Telephone | 818-493-4315
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Fax |
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Provider Business Mailing Address
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Address Line | 4518 LONE TREE WAY
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City | ANTIOCH
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State | CA
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Zip | 94531-7414
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS103125
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License Number State | CA
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