Provider Demographics
NPI:1023520988
Name:LAREDO, CAMILA (DDS)
Entity type:Individual
Prefix:DR
First Name:CAMILA
Middle Name:
Last Name:LAREDO
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 1:2502 LAVERNE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-4418
Mailing Address - Country:US
Mailing Address - Phone:832-368-9015
Mailing Address - Fax:
Practice Address - Street 1:2502 LAVERNE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-4418
Practice Address - Country:US
Practice Address - Phone:832-368-9015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice