Provider Demographics
NPI:1497856553
Name:SEITLIN, LAWRENCE S (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:S
Last Name:SEITLIN
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 1:1014 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5787
Mailing Address - Country:US
Mailing Address - Phone:704-375-2030
Mailing Address - Fax:704-371-4480
Practice Address - Street 1:1014 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5787
Practice Address - Country:US
Practice Address - Phone:704-375-2030
Practice Address - Fax:704-371-4480
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice