Provider Demographics
NPI:1790880789
Name:LAUBMEIER, JEFFREY W (DMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:W
Last Name:LAUBMEIER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33175 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012
Mailing Address - Country:US
Mailing Address - Phone:216-650-4380
Mailing Address - Fax:
Practice Address - Street 1:14583 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4325
Practice Address - Country:US
Practice Address - Phone:216-226-3084
Practice Address - Fax:216-226-7998
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30021888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist