Provider Demographics
NPI:1558446914
Name:EISENMAN, LAWRENCE II (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:EISENMAN
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:EISENMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30 0122081223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry