Provider Demographics
NPI:1649503004
Name:TEODORU, LAURENTIU (DMD)
Entity type:Individual
Prefix:DR
First Name:LAURENTIU
Middle Name:
Last Name:TEODORU
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 1:866 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4316
Mailing Address - Country:US
Mailing Address - Phone:954-748-7771
Mailing Address - Fax:954-748-7776
Practice Address - Street 1:866 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-4316
Practice Address - Country:US
Practice Address - Phone:954-748-7771
Practice Address - Fax:954-748-7776
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN153301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice