Individual
DANE LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2000
Mailing address
62 ELDON AVE, LANSDOWNE, PA 19050-1815
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
13771
CT
Other
Enumeration date
05/17/2023
Last updated
05/26/2023
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