MEDICARE: A. PAUL LAWRENCE DDS.PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	012337	MI

General Provider Information

NPI Number	:	1861619926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A. PAUL LAWRENCE DDS.PLLC

Provider Business Mailing Address
First Line	:	146 S INDUSTRIAL DR
Second Line	:
City	:	SALINE
State	:	MI
Zip	:	48176-9493
Country	:	US
Telephone Number	:	734-944-3594
Fax Number	:	734-944-3597

Provider Business Practice Location Address
First Line	:	146 S INDUSTRIAL DR
Second Line	:
City	:	SALINE
State	:	MI
Zip	:	48176-9493
Country	:	US
Telephone Number	:	734-944-3594
Fax Number	:	734-944-3597

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. DONNA JEAN JEPPESEN
Credential	:
Telephone Number	:	734-944-3594

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	08/22/2020

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