Provider Demographics
NPI:1346323748
Name:GASTON, LAWRENCE GAIL (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:GAIL
Last Name:GASTON
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Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:5976 HOWDER SHELL RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-4106
Mailing Address - Country:US
Mailing Address - Phone:314-731-0470
Mailing Address - Fax:314-731-0473
Practice Address - Street 1:5976 HOWDER SHELL RD
Practice Address - Street 2:SUITE 207
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-4106
Practice Address - Country:US
Practice Address - Phone:314-731-0470
Practice Address - Fax:314-731-0473
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MO5231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics