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Individual

LAWRENCE H KENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1912 LEXINGTON AVE N, ROSEVILLE, MN 55113-6113
(651) 636-2420
(651) 482-6144
Mailing address
1912 LEXINGTON AVE N STE 150, 700 VILLAGE CENTER DRIVE, #170, NORTH OAKS, MN 55127, ROSEVILLE, MN 55113-6100
(651) 636-2420
(651) 636-3199

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4197
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33703200
WI
Enumeration date
06/22/2005
Last updated
10/11/2007
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