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NPI Code Detail

MEDICARE: DR. LAWRENCE THOMAS WEIR DDS

MEDICARE: DR. LAWRENCE THOMAS WEIR DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2971SC

General Provider Information

NPI Number : 1114008679
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE THOMAS WEIR DDS
Provider Business Mailing Address
First Line : 113 WAPPOO CREEK DR
Second Line : SUITE 5
City : CHARLESTON
State : SC
Zip : 29412-2136
Country : US
Telephone Number : 843-762-1234
Fax Number : 843-762-9142
Provider Business Practice Location Address
First Line : 113 WAPPOO CREEK DR
Second Line : SUITE 5
City : CHARLESTON
State : SC
Zip : 29412-2136
Country : US
Telephone Number : 843-762-1234
Fax Number : 843-762-9142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 10/02/2007

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Directions to “ DR. LAWRENCE THOMAS WEIR DDS” Practice Location

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