Provider Demographics
NPI:1538288378
Name:LAWRENCE EISENMAN, DDS, INC.
Entity Type:Organization
Organization Name:LAWRENCE EISENMAN, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-878-8303
Mailing Address - Street 1:1101 NORTON RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8956
Mailing Address - Country:US
Mailing Address - Phone:614-878-8303
Mailing Address - Fax:614-851-1055
Practice Address - Street 1:1101 NORTON RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8956
Practice Address - Country:US
Practice Address - Phone:614-878-8303
Practice Address - Fax:614-851-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty