Provider Demographics
NPI:1588952683
Name:WESTOVER, LAURA JEANE (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JEANE
Last Name:WESTOVER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:JEANE
Other - Last Name:WESTOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:8484 MARKET ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4169
Mailing Address - Country:US
Mailing Address - Phone:440-266-1740
Mailing Address - Fax:440-266-1746
Practice Address - Street 1:8484 MARKET ST STE 2
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4169
Practice Address - Country:US
Practice Address - Phone:440-266-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH30-0238711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program