Provider Demographics
NPI:1659741023
Name:ESPOSITO, LAURIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:
Last Name:ESPOSITO
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 1:9116 SHORE FRONT PKWY APT 4G
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-1557
Mailing Address - Country:US
Mailing Address - Phone:718-644-7361
Mailing Address - Fax:
Practice Address - Street 1:9116 SHORE FRONT PKWY APT 4G
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1557
Practice Address - Country:US
Practice Address - Phone:718-644-7361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042802122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist