Individual
THOMAS JACOB LAWLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1431 S BLUFFVIEW DR, WICHITA, KS 67218-3010
(316) 686-7155
Mailing address
924 E MORRISON DR, DERBY, KS 67037-1937
(620) 262-6077
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61889
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/18/2022
Last updated
06/06/2022
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