Provider Demographics
NPI:1962694141
Name:ROH, LAUREEN M (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREEN
Middle Name:M
Last Name:ROH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1480 S HARBOR BLVD
Mailing Address - Street 2:STE 5
Mailing Address - City:LAHABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631
Mailing Address - Country:US
Mailing Address - Phone:714-870-5200
Mailing Address - Fax:714-870-5481
Practice Address - Street 1:1480 S HARBOR BLVD
Practice Address - Street 2:STE 5
Practice Address - City:LAHABRA
Practice Address - State:CA
Practice Address - Zip Code:90631
Practice Address - Country:US
Practice Address - Phone:714-870-5200
Practice Address - Fax:714-870-5481
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403011223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics