Provider Demographics
NPI:1780815381
Name:STONE, LAURIE LEE (RDH)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:LEE
Last Name:STONE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 W CHIMES TOWER DR
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-6642
Mailing Address - Country:US
Mailing Address - Phone:602-568-2215
Mailing Address - Fax:
Practice Address - Street 1:1227 W CHIMES TOWER DR
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-6642
Practice Address - Country:US
Practice Address - Phone:602-568-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1429124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist