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General NPI Number Information
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NPI Number | 1902203730
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Entity Type | Individual
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Provider Name | STEPHEN AARON LAWRENCE DDS, DCH, JCM, THPSY
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Gender | Male
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 11/21/2014
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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 |
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Name |
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Credential |
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Telephone |
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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 | 34865
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License Number State | CA
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