Provider Demographics
NPI:1578870481
Name:CAPATI, LAURA RICHARDS (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:RICHARDS
Last Name:CAPATI
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 US HIGHWAY 61
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4109
Mailing Address - Country:US
Mailing Address - Phone:636-232-9869
Mailing Address - Fax:
Practice Address - Street 1:1431 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4109
Practice Address - Country:US
Practice Address - Phone:636-232-9869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2013-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009021095122300000X, 1223P0300X
IL019027682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist