Provider Demographics
NPI:1487309811
Name:FOLGUEIRA JOVA, LAURA (DDS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FOLGUEIRA JOVA
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 1:12856 SW 207TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5516
Mailing Address - Country:US
Mailing Address - Phone:786-210-7204
Mailing Address - Fax:
Practice Address - Street 1:12856 SW 207TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5516
Practice Address - Country:US
Practice Address - Phone:786-210-7204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN296391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program