Provider Demographics
NPI:1114998887
Name:MARCHELYA, LAWRENCE STEVEN (DDS)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:STEVEN
Last Name:MARCHELYA
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 1:105 BREWHOUSE AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-8616
Mailing Address - Country:US
Mailing Address - Phone:757-220-1801
Mailing Address - Fax:
Practice Address - Street 1:NAVAL WEAPONS STATION
Practice Address - Street 2:BRANCH MEDICAL CLINIC, BLDG 1806
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23690-0090
Practice Address - Country:US
Practice Address - Phone:757-314-6130
Practice Address - Fax:757-887-4429
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010083461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice