Provider Demographics
NPI:1326161373
Name:HARKINS, LAWRENCE MICHAEL (DMD)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:MICHAEL
Last Name:HARKINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3364 BRIAN S RD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2105
Mailing Address - Country:US
Mailing Address - Phone:727-781-0005
Mailing Address - Fax:
Practice Address - Street 1:3410 E LAKE RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2401
Practice Address - Country:US
Practice Address - Phone:727-784-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11605122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist