Provider Demographics
NPI:1831571355
Name:BOVEE, LAURA DAWN (RDH)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DAWN
Last Name:BOVEE
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 1:32316 E HISTORIC COLUMBIA RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:CORBETT
Mailing Address - State:OR
Mailing Address - Zip Code:97019-9646
Mailing Address - Country:US
Mailing Address - Phone:503-422-9786
Mailing Address - Fax:
Practice Address - Street 1:32316 E HISTORIC COLUMBIA RIVER HWY
Practice Address - Street 2:
Practice Address - City:CORBETT
Practice Address - State:OR
Practice Address - Zip Code:97019-9646
Practice Address - Country:US
Practice Address - Phone:503-422-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-20
Last Update Date:2015-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6140124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist