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General NPI Number Information
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NPI Number | 1922296839
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Entity Type | Individual
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Provider Name | LAWRENCE EDWIN CALLEY D.D.S., M.S., P.C.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 352 12TH ST SUITE 1
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City | PLAINWELL
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State | MI
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Zip | 49080
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Country | US
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Telephone | 269-685-5761
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Fax | 269-685-8985
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Provider Business Mailing Address
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Address Line | 352 12TH ST SUITE 1
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City | PLAINWELL
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State | MI
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Zip | 49080
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Country | US
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Telephone | 269-685-5761
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Fax | 269-685-8985
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2901011537
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License Number State | MI
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