Provider Demographics
NPI:1558700146
Name:LAWRENCE G. STAFF, DMD, PA
Entity Type:Organization
Organization Name:LAWRENCE G. STAFF, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:G
Authorized Official - Last Name:STAFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-584-8639
Mailing Address - Street 1:2001 WEST BAY DR.
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770
Mailing Address - Country:US
Mailing Address - Phone:727-584-8639
Mailing Address - Fax:727-584-8519
Practice Address - Street 1:2001 WEST BAY DR.
Practice Address - Street 2:LAWRENCE G. STAFF, D.M.D.
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770
Practice Address - Country:US
Practice Address - Phone:727-584-8639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty