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General NPI Number Information
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NPI Number | 1154514743
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Entity Type | Organization
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Legal Business Name | LAWRENCE A. KLAR, D.D.S, M.S., LTD.
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 5241 PROVIDENCE RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4201
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Country | US
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Telephone | 757-495-3110
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Fax |
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Provider Business Mailing Address
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Address Line | 5241 PROVIDENCE RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4201
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Country | US
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Telephone | 757-495-3110
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. LAWRENCE A. KLAR
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Credential | D.D.S,M.S.
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Telephone | 757-495-3110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 4256
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License Number State | VA
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