Provider Demographics
NPI:1598924078
Name:ROMNEY, LAWRENCE CLARK (DMD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:CLARK
Last Name:ROMNEY
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 1:525 E 100 S
Mailing Address - Street 2:#430
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-4210
Mailing Address - Country:US
Mailing Address - Phone:801-355-8677
Mailing Address - Fax:801-662-3908
Practice Address - Street 1:525 E 100 S
Practice Address - Street 2:#430
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-4210
Practice Address - Country:US
Practice Address - Phone:801-355-8677
Practice Address - Fax:801-662-3908
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6331645-99221223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry