Organization
LAURA A GUTTORMSEN DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA A GUTTORMSEN DDS (GENERAL DENIST/OFFICER)
(262) 945-7970
Entity
Organization
Contact information
Practice address
6402 SHERIDAN RD, KENOSHA, WI 53143-5028
(262) 654-2261
(262) 657-6933
Mailing address
6402 SHERIDAN RD, KENOSHA, WI 53143-5028
(262) 654-2261
(262) 657-6933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6307-15
—
1223G0001X
General Practice Dentistry
Primary
6307-15
—
Other
Enumeration date
07/18/2017
Last updated
07/21/2022
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