Organization
J. RICHARD LAWRENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH RICHARD LAWRENCE D.D.S. (DENTIST OWNER)
(631) 266-5061
Entity
Organization
Contact information
Practice address
206 CLAY PITTS RD, EAST NORTHPORT, NY 11731-3423
(631) 266-5061
(631) 266-5065
Mailing address
206 CLAY PITTS ROAD, EAST NORTHPORT, NY 11731-3421
(631) 266-5061
(631) 266-5065
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
36108
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01200146
—
NY
Enumeration date
09/22/2010
Last updated
09/22/2010
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