Provider Demographics
NPI:1710352729
Name:GERLANTS, LAURA (RDH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GERLANTS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 FOREST BAY DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-4292
Mailing Address - Country:US
Mailing Address - Phone:248-875-9836
Mailing Address - Fax:
Practice Address - Street 1:1318 FOREST BAY DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-4292
Practice Address - Country:US
Practice Address - Phone:248-875-9836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902016439124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist