Provider Demographics
NPI:1417260225
Name:KINLAW, LAURA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:R
Last Name:KINLAW
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 1:411 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-4469
Mailing Address - Country:US
Mailing Address - Phone:513-821-0659
Mailing Address - Fax:513-821-0656
Practice Address - Street 1:411 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:OH
Practice Address - Zip Code:45215-4469
Practice Address - Country:US
Practice Address - Phone:513-821-0659
Practice Address - Fax:513-821-0656
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300232441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice