1902651318 NPI number — DENTISTS OF INTERQUEST AND ORTHODONTICS

Table of content: DR. MARIA LUZ LAO MD (NPI 1801851498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902651318 NPI number — DENTISTS OF INTERQUEST AND ORTHODONTICS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENTISTS OF INTERQUEST AND ORTHODONTICS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902651318
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 920050
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75392-0050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1824 DEMOCRACY POINT
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-867-4291
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2024

Additional Information

Authorized Official

Authorized Official Last Name:
FRAISER
Authorized Official First Name:
EVAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
714-845-8500

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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