Healthcare Provider Details

I. General information

NPI: 1902914492
Provider Name (Legal Business Name): DAVID LAWAYNE LAW DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 NORTH MAIN STREET
ARAB AL
35016
US

IV. Provider business mailing address

320 NORTH MAIN STREET
ARAB AL
35016
US

V. Phone/Fax

Practice location:
  • Phone: 256-586-6120
  • Fax: 256-586-6975
Mailing address:
  • Phone: 256-586-6120
  • Fax: 256-586-6975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4716
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: