Provider Demographics
NPI:1275621864
Name:LAUF, ROBERT C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:LAUF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:ND
Mailing Address - Zip Code:58257-1450
Mailing Address - Country:US
Mailing Address - Phone:701-788-4064
Mailing Address - Fax:701-788-9090
Practice Address - Street 1:37 1/2 MAIN ST E
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:ND
Practice Address - Zip Code:58257-1450
Practice Address - Country:US
Practice Address - Phone:701-788-4064
Practice Address - Fax:701-788-9090
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1794122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1454880Medicaid