Provider Demographics
NPI:1346321031
Name:GITTESS, LAURIE B (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:B
Last Name:GITTESS
Suffix:
Gender:F
Credentials:DDS MSD
Other - Prefix:DR
Other - First Name:LAURIE
Other - Middle Name:J
Other - Last Name:BRIGHTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS MSD
Mailing Address - Street 1:1625 N COMMERCE PKWY
Mailing Address - Street 2:SUITE 317
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326
Mailing Address - Country:US
Mailing Address - Phone:954-389-2345
Mailing Address - Fax:954-389-0972
Practice Address - Street 1:1625 N COMMERCE PKWY
Practice Address - Street 2:SUITE 317
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326
Practice Address - Country:US
Practice Address - Phone:954-389-2345
Practice Address - Fax:954-389-2345
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00134741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics