Provider Demographics
NPI:1235442567
Name:LAWHORNE, ANDREW PHILLIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PHILLIP
Last Name:LAWHORNE
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 1:464 MONTAUK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4606
Mailing Address - Country:US
Mailing Address - Phone:860-443-3634
Mailing Address - Fax:
Practice Address - Street 1:464 MONTAUK AVE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4606
Practice Address - Country:US
Practice Address - Phone:860-443-3634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0102661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice