Provider Demographics
NPI:1437373750
Name:KORENMAN, LAWRENCE JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAY
Last Name:KORENMAN
Suffix:
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 1:1410 N. PLANO RD
Mailing Address - Street 2:STE 200
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2427
Mailing Address - Country:US
Mailing Address - Phone:972-231-0585
Mailing Address - Fax:972-231-5753
Practice Address - Street 1:1410 N PLANO RD
Practice Address - Street 2:STE 200
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2427
Practice Address - Country:US
Practice Address - Phone:972-231-0585
Practice Address - Fax:972-231-5753
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice