Provider Demographics
NPI:1033371000
Name:LAUBACH, JENNIFER MARGARET ELSIE (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARGARET ELSIE
Last Name:LAUBACH
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 1:8701 W PARMER LN
Mailing Address - Street 2:STE. 1124
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4941
Mailing Address - Country:US
Mailing Address - Phone:512-258-3384
Mailing Address - Fax:512-258-9433
Practice Address - Street 1:8701 W PARMER LN
Practice Address - Street 2:STE. 1124
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4941
Practice Address - Country:US
Practice Address - Phone:512-258-3384
Practice Address - Fax:512-258-9433
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice