Provider Demographics
NPI:1548221971
Name:LAURICH, DENNIS G (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:G
Last Name:LAURICH
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 1:18618 MIDDLEBELT
Mailing Address - Street 2:#105
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152
Mailing Address - Country:US
Mailing Address - Phone:248-476-1960
Mailing Address - Fax:248-476-6727
Practice Address - Street 1:18618 MIDDLEBELT
Practice Address - Street 2:#105
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152
Practice Address - Country:US
Practice Address - Phone:248-476-1960
Practice Address - Fax:248-476-6727
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11831122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11831OtherSTATE LIC