Provider Demographics
NPI:1114121910
Name:REED, LAWRENCE PERRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:PERRY
Last Name:REED
Suffix:
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 1:5800 SANTA ROSA RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-7056
Mailing Address - Country:US
Mailing Address - Phone:805-987-8782
Mailing Address - Fax:805-987-5649
Practice Address - Street 1:5800 SANTA ROSA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-7056
Practice Address - Country:US
Practice Address - Phone:805-987-8782
Practice Address - Fax:805-987-5649
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice