Individual
DR. LAWRENCE SHULTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S. MSD
Contact information
Practice address
3549 E BROWN RD STE 102, MESA, AZ 85213-5508
(480) 634-5686
(888) 620-3210
Mailing address
3549 E BROWN RD STE 102, MESA, AZ 85213-5508
(480) 634-5686
(888) 620-3210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D6953
AZ
1223P0221X
Pediatric Dentistry
Primary
D6953
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117337
—
AZ
Enumeration date
03/26/2007
Last updated
11/24/2015
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