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General NPI Number Information
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NPI Number | 1871148098
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Entity Type | Organization
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Legal Business Name | LAURA J WESTOVER DDS LLC
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 8484 MARKET ST
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City | MENTOR
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State | OH
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Zip | 44060-4169
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Country | US
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Telephone | 440-266-1740
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Fax |
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Provider Business Mailing Address
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Address Line | 29650 SHAKER BLVD
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City | PEPPER PIKE
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State | OH
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Zip | 44124-5035
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Country | US
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Telephone | 419-290-8422
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURA WESTOVER
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Credential |
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Telephone | 419-290-8422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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