Robert A Lauer, DDS
Individual provider Active NPI Dentist · Mound, MN
NPI 1205913282 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205913282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6334 (MN)
- Practice address
- 5585 Shoreline Blvd
Mound, MN 55364 - Phone
- (952) 472-1121
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6334 | MN | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6334 | MN | Yes |
Addresses
Primary practice location
5585 Shoreline Blvd
Mound, MN 55364
Mailing address
5585 Shoreline Blvd
Mound, MN 55364
Phone (952) 472-1121
Other providers in Mound, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.