J. Richard Lawrence | |
206 Clay Pitts Rd East Northport NY 11731-3423 | |
(631) 266-5061 | |
(631) 266-5065 |
Full Name | J. Richard Lawrence |
---|---|
Speciality | Dentist |
Location | 206 Clay Pitts Rd, East Northport, New York |
Authorized Official Name and Position | Joseph Richard Lawrence (DENTIST OWNER) |
Authorized Official Contact | 6312665061 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
J. Richard Lawrence 206 Clay Pitts Road East Northport NY 11731-3421 Ph: (631) 266-5061 | J. Richard Lawrence 206 Clay Pitts Rd East Northport NY 11731-3423 Ph: (631) 266-5061 |
NPI Number | 1467760678 |
---|---|
Provider Enumeration Date | 09/22/2010 |
Last Update Date | 09/22/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467760678 | NPI | - | NPPES |
01200146 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 36108 (New York) | Primary |
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› Verified 9 days ago
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