Provider Demographics
NPI:1346537016
Name:SHIN, LAWRENCE MINHO (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:MINHO
Last Name:SHIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MIN
Other - Middle Name:HO
Other - Last Name:SHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2732 CASCADE COVE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-7604
Mailing Address - Country:US
Mailing Address - Phone:940-641-0275
Mailing Address - Fax:
Practice Address - Street 1:2732 CASCADE COVE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-7604
Practice Address - Country:US
Practice Address - Phone:940-641-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX270811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice