Provider Demographics
NPI:1588797500
Name:SENZER, LAWRENCE IRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:IRA
Last Name:SENZER
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 1:727 N BROADWAY
Mailing Address - Street 2:SUITE B-3
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2348
Mailing Address - Country:US
Mailing Address - Phone:516-795-2791
Mailing Address - Fax:516-798-8164
Practice Address - Street 1:727 N BROADWAY
Practice Address - Street 2:SUITE B-3
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2348
Practice Address - Country:US
Practice Address - Phone:516-795-2791
Practice Address - Fax:516-798-8164
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0387111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice