Individual
KAITLIN LAXER DANZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7820 BALLANTYNE COMMONS PKWY STE 200, CHARLOTTE, NC 28277-2889
(704) 759-0000
Mailing address
7820 BALLANTYNE COMMONS PKWY STE 200, CHARLOTTE, NC 28277-2889
(704) 759-0000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.026052
OH
1223P0221X
Pediatric Dentistry
Primary
30.026052
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0392793
—
OH
Enumeration date
03/06/2019
Last updated
12/12/2022
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