Provider Demographics
NPI:1255492617
Name:SAUNDERS, LAWRENCE ALAN (DMD,MS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ALAN
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 GEORGIA LN
Mailing Address - Street 2:
Mailing Address - City:PORTOLA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94028-7929
Mailing Address - Country:US
Mailing Address - Phone:650-544-5297
Mailing Address - Fax:650-851-9893
Practice Address - Street 1:165 GEORGIA LN
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7929
Practice Address - Country:US
Practice Address - Phone:650-544-5297
Practice Address - Fax:650-851-9893
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA202641223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery