Provider Demographics
NPI:1962133017
Name:LOMELI, LAURA ARLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ARLEN
Last Name:LOMELI
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 1:8306 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-2081
Mailing Address - Country:US
Mailing Address - Phone:956-236-3615
Mailing Address - Fax:
Practice Address - Street 1:5129 N GARLAND AVE STE 700
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2746
Practice Address - Country:US
Practice Address - Phone:972-276-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385381223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice