Provider Demographics
NPI:1407878085
Name:KLEIN, LAURA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:KLEIN
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 1:32 COURT ST
Mailing Address - Street 2:SUITE 1401
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4404
Mailing Address - Country:US
Mailing Address - Phone:718-636-0435
Mailing Address - Fax:718-857-6100
Practice Address - Street 1:32 COURT ST
Practice Address - Street 2:SUITE 1401
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4404
Practice Address - Country:US
Practice Address - Phone:718-636-0435
Practice Address - Fax:718-857-6100
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0370541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00809370Medicaid