Provider Demographics
NPI:1811058654
Name:HARE, LORI (DDS)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:
Last Name:HARE
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 1:1326 E 43RD CT STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4155
Mailing Address - Country:US
Mailing Address - Phone:918-749-0303
Mailing Address - Fax:918-749-0304
Practice Address - Street 1:201 N LYNN RIGGS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-6815
Practice Address - Country:US
Practice Address - Phone:918-343-4300
Practice Address - Fax:918-342-4697
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK51381223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice