Provider Demographics
NPI:1700314986
Name:VO, LAURA (DDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:VO
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 1:6400 CANDLEWOOD CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-6419
Mailing Address - Country:US
Mailing Address - Phone:931-703-5441
Mailing Address - Fax:
Practice Address - Street 1:8950 US HIGHWAY 64 STE 108
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-4566
Practice Address - Country:US
Practice Address - Phone:901-308-5952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-31
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10534122300000X
MS3972-17122300000X
WADE61040095122300000X
AL6613122300000X
OK7370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist