Individual
JACK LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 UNION BLVD, ALLENTOWN, PA 18109-1676
(640) 437-5353
Mailing address
135 3RD AVE, APT 4K, MINEOLA, NY 11501-3924
(570) 856-0615
(570) 856-0615
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
057478
NY
Other
Enumeration date
09/13/2011
Last updated
06/04/2016
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