Provider Demographics
NPI:1235353921
Name:KLEIN, LAWRENCE NEIL SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:NEIL
Last Name:KLEIN
Suffix:SR
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 1:2000 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8012
Mailing Address - Country:US
Mailing Address - Phone:727-894-3065
Mailing Address - Fax:727-823-2312
Practice Address - Street 1:2000 5TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8012
Practice Address - Country:US
Practice Address - Phone:727-894-3065
Practice Address - Fax:727-823-2312
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 15683122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist