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General NPI Number Information
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NPI Number | 1871995647
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Entity Type | Organization
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Legal Business Name | STEPHEN A. LAWRENCE, DDS, INC.
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 09/23/2014
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Provider Practice Location Address
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Address Line | 785 GRAND AVE SUITE 206
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City | CARLSBAD
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State | CA
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Zip | 92008-2370
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Country | US
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Telephone | 760-729-9050
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Fax | 760-729-3572
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Provider Business Mailing Address
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Address Line | 785 GRAND AVE SUITE 206
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City | CARLSBAD
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State | CA
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Zip | 92008-2370
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Country | US
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Telephone | 760-729-9050
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Fax | 760-729-3572
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. STEPHEN AARON LAWRENCE
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Credential | DDS
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Telephone | 760-729-9050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 34865
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License Number State | CA
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