Provider Demographics
NPI:1710222724
Name:DENNIS, LAURA ELIZABETH (DVM)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELIZABETH
Last Name:DENNIS
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 KEARNY MESA RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1313
Mailing Address - Country:US
Mailing Address - Phone:858-699-3104
Mailing Address - Fax:858-569-0660
Practice Address - Street 1:5610 KEARNY MESA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1313
Practice Address - Country:US
Practice Address - Phone:858-699-3104
Practice Address - Fax:858-569-0660
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-02
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18176174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18176OtherVETERINARY MEDICAL BOARD LICENSE NUMBER