Provider Demographics
NPI:1497849814
Name:HODES, LAWRENCE M (DMD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:HODES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-3526
Mailing Address - Country:US
Mailing Address - Phone:913-248-8880
Mailing Address - Fax:913-248-8155
Practice Address - Street 1:7450 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-3526
Practice Address - Country:US
Practice Address - Phone:913-248-8880
Practice Address - Fax:913-248-8155
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS606191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice