Organization
LAWRENCE M KOTLER DDS MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE MARK KOTLER DDS MS (OWNER)
(703) 931-6600
Entity
Organization
Contact information
Practice address
3543 WEST BRADDOCK RD, SUITE E1 BRAD LEE OFFICE BUILDING, ALEXANDRIA, VA 22301-1903
(703) 931-6600
(703) 931-4594
Mailing address
3543 WEST BRADDOCK RD, SUITE E1 BRAD LEE OFFICE BUILDING, ALEXANDRIA, VA 22301-1903
(703) 931-6600
(703) 931-4594
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401004446
VA
1223E0200X
Endodontics
0401006677
VA
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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