Provider Demographics
NPI:1295857134
Name:LAUDER, K MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:K
Middle Name:MICHAEL
Last Name:LAUDER
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 1:3333 SO WADSWORTH BLVD
Mailing Address - Street 2:D325
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5121
Mailing Address - Country:US
Mailing Address - Phone:303-989-8551
Mailing Address - Fax:303-989-8596
Practice Address - Street 1:3333 SO WADSWORTH BLVD
Practice Address - Street 2:D325
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5121
Practice Address - Country:US
Practice Address - Phone:303-989-8551
Practice Address - Fax:303-989-8596
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD1000076122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist