Provider Demographics
NPI:1154498483
Name:ASHMAN, LAWRENCE M (DDS)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:ASHMAN
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 1:1500 E MEDICAL CENTER DR
Mailing Address - Street 2:SPC 5018, TC B1-208
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5000
Mailing Address - Country:US
Mailing Address - Phone:734-936-5955
Mailing Address - Fax:734-936-5941
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:SPC 5018, TC B1-208
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-936-5955
Practice Address - Fax:734-936-5941
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901010625122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID1062500OtherBCBS OF MI
MI1956310180OtherBCBS OF MI
MID1062500OtherBCBS OF MI