Provider Demographics
NPI:1104913607
Name:MENEES MOORE, LAURA M (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:MENEES MOORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:MENEES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:8340 MISSION RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66206
Mailing Address - Country:US
Mailing Address - Phone:913-362-4488
Mailing Address - Fax:913-362-6652
Practice Address - Street 1:8340 MISSION RD
Practice Address - Street 2:STE 118
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66206
Practice Address - Country:US
Practice Address - Phone:913-362-4488
Practice Address - Fax:913-362-6652
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60047122300000X
MO2000157779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist