Provider Demographics
NPI:1255487658
Name:VICTOR A LAWRENCE DDS INC
Entity Type:Organization
Organization Name:VICTOR A LAWRENCE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-435-8202
Mailing Address - Street 1:5462 FOLKESTONE DRIVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459
Mailing Address - Country:US
Mailing Address - Phone:937-434-2344
Mailing Address - Fax:
Practice Address - Street 1:6822 LOOP ROAD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-2159
Practice Address - Country:US
Practice Address - Phone:937-434-2344
Practice Address - Fax:937-435-8317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH110371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty