Provider Demographics
NPI:1275742785
Name:LAWLER, EDWARD THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:THOMAS
Last Name:LAWLER
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 1:848 MAIN ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3358
Mailing Address - Country:US
Mailing Address - Phone:406-652-1168
Mailing Address - Fax:406-256-2243
Practice Address - Street 1:848 MAIN ST
Practice Address - Street 2:SUITE #1
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3358
Practice Address - Country:US
Practice Address - Phone:406-256-2243
Practice Address - Fax:406-256-2243
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1513122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist