Provider Demographics
NPI:1417026543
Name:ARTHUR, LAWRENCE KEVIN (DDSPA)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:KEVIN
Last Name:ARTHUR
Suffix:
Gender:M
Credentials:DDSPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 ENCHANTED OAKS DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-9010
Mailing Address - Country:US
Mailing Address - Phone:919-832-8170
Mailing Address - Fax:
Practice Address - Street 1:2385 TIMBER DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-2586
Practice Address - Country:US
Practice Address - Phone:919-772-1434
Practice Address - Fax:919-772-0537
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 53741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU41424Medicare UPIN