Provider Demographics
NPI:1942466636
Name:DANOFF, LAURA HERMAN (DMD05/30/1957)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:HERMAN
Last Name:DANOFF
Suffix:
Gender:F
Credentials:DMD05/30/1957
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1717
Mailing Address - Country:US
Mailing Address - Phone:516-773-4133
Mailing Address - Fax:
Practice Address - Street 1:4 VISTA DR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1717
Practice Address - Country:US
Practice Address - Phone:516-773-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0372131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics