Provider Demographics
NPI:1326038266
Name:DUFFIELD, LAWRENCE DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:DAVID
Last Name:DUFFIELD
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 1:2009 CROOKS RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-4049
Mailing Address - Country:US
Mailing Address - Phone:248-541-1388
Mailing Address - Fax:
Practice Address - Street 1:2009 CROOKS RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-4049
Practice Address - Country:US
Practice Address - Phone:248-541-1388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI013218122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist