Individual
MARK A LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2570 BROOKSTONE CENTRE PKWY, SUITE 100, COLUMBUS, GA 31904-4672
(706) 327-6262
(706) 327-1250
Mailing address
2570 BROOKSTONE CENTRE PARKWAY, SUITE 100, COLUMBUS, GA 31904-4672
(706) 327-6262
(706) 327-1250
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
GA011761
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000831267A
—
GA
Enumeration date
08/30/2006
Last updated
09/13/2010
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