Provider Demographics
NPI:1598071961
Name:GROOP, LAWRENCE GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:GEORGE
Last Name:GROOP
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 N HUNT HWY STE 127
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85132-6922
Mailing Address - Country:US
Mailing Address - Phone:520-723-0655
Mailing Address - Fax:
Practice Address - Street 1:3385 N HUNT HWY STE 127
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-6922
Practice Address - Country:US
Practice Address - Phone:520-723-0655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD078191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice