# LAWRENCE DENTAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952505562
- **Authorized official:** DR. LAWRENCE STEWART DAVIS DDS (OWNER)
- **Authorized official phone:** (573) 636-6220

## Contact information

- **Practice address:** 915 SOUTHWEST BLVD STE D, JEFFERSON CITY, MO 65109-5014
- **Practice address phone:** (573) 636-6220
- **Practice address fax:** (573) 636-2155
- **Mailing address:** 915 SOUTHWEST BLVD STE D, JEFFERSON CITY, MO 65109-5014
- **Mailing address phone:** (573) 636-6220
- **Mailing address fax:** (573) 636-2155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE014989 | MO | Yes |

## Other

- **Enumeration date:** 06/14/2007
- **Last updated:** 10/31/2007