Individual
DR. LAWRENCE HENRY SPROUSE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2452 BLACK ROCK TPKE, SUITE 12, FAIRFIELD, CT 06825-2407
(203) 374-3886
Mailing address
2452 BLACK ROCK TPKE STE 12, FAIRFIELD, CT 06825-2407
(203) 374-3886
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4035
CT
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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