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General NPI Number Information
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NPI Number | 1255487658
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Entity Type | Organization
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Legal Business Name | VICTOR A LAWRENCE DDS INC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6822 LOOP ROAD
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City | DAYTON
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State | OH
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Zip | 45459-2159
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Country | US
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Telephone | 937-434-2344
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Fax | 937-435-8317
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Provider Business Mailing Address
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Address Line | 5462 FOLKESTONE DRIVE
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City | DAYTON
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State | OH
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Zip | 45459
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Country | US
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Telephone | 937-434-2344
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICTOR A LAWRENCE JR.
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Credential | DDS
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Telephone | 937-435-8202
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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 | 11037
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License Number State | OH
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