Provider Demographics
NPI:1417040585
Name:LAWRENCE, DENARD THOMAS II (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENARD
Middle Name:THOMAS
Last Name:LAWRENCE
Suffix:II
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 1:3302 BRIDGES ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557
Mailing Address - Country:US
Mailing Address - Phone:252-247-5683
Mailing Address - Fax:252-247-1104
Practice Address - Street 1:3302 BRIDGES ST
Practice Address - Street 2:SUITE H
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557
Practice Address - Country:US
Practice Address - Phone:252-247-5683
Practice Address - Fax:252-247-1104
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7450122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1813869OtherUNITED CONCORDIA
902GZOtherBXBS