Provider Demographics
NPI:1144423559
Name:MCDONALD, LAWRENCE JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAMES
Last Name:MCDONALD
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 1:17705 HALE AVE
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-4340
Mailing Address - Country:US
Mailing Address - Phone:408-779-9335
Mailing Address - Fax:408-782-1087
Practice Address - Street 1:17705 HALE AVE
Practice Address - Street 2:SUITE A-1
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-4340
Practice Address - Country:US
Practice Address - Phone:408-779-9335
Practice Address - Fax:408-782-1087
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26895122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist