Provider Demographics
NPI:1467869081
Name:LAIMINGER, STACEY ELAINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:ELAINE
Last Name:LAIMINGER
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:PO BOX 1300
Mailing Address - Street 2:
Mailing Address - City:PAONIA
Mailing Address - State:CO
Mailing Address - Zip Code:81428-1300
Mailing Address - Country:US
Mailing Address - Phone:970-527-3757
Mailing Address - Fax:
Practice Address - Street 1:404 2ND STREET
Practice Address - Street 2:
Practice Address - City:PAONIA
Practice Address - State:CO
Practice Address - Zip Code:81428
Practice Address - Country:US
Practice Address - Phone:970-527-3757
Practice Address - Fax:970-527-4029
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002022601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice