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General NPI Number Information
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NPI Number | 1558700146
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Entity Type | Organization
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Legal Business Name | LAWRENCE G. STAFF, DMD, PA
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 2001 WEST BAY DR. LAWRENCE G. STAFF, D.M.D.
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City | LARGO
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State | FL
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Zip | 33770
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Country | US
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Telephone | 727-584-8639
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 WEST BAY DR.
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City | LARGO
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State | FL
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Zip | 33770
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Country | US
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Telephone | 727-584-8639
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Fax | 727-584-8519
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LAWRENCE G. STAFF
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Credential | DMD
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Telephone | 727-584-8639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15746
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License Number State | FL
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