Provider Demographics
NPI:1043212368
Name:LANG, LAURENCE C II (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:C
Last Name:LANG
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W. WACKERLY
Mailing Address - Street 2:SUITE 3700
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:46840
Mailing Address - Country:US
Mailing Address - Phone:989-832-2151
Mailing Address - Fax:
Practice Address - Street 1:555 W WACKERLY ST
Practice Address - Street 2:STE 3700
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4713
Practice Address - Country:US
Practice Address - Phone:989-832-2515
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice