Provider Demographics
NPI:1639290141
Name:VOSS, LAWRENCE RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:RICHARD
Last Name:VOSS
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 1:514 NA WA TA AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3624
Mailing Address - Country:US
Mailing Address - Phone:847-394-5304
Mailing Address - Fax:847-394-5304
Practice Address - Street 1:514 NA WA TA AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-3624
Practice Address - Country:US
Practice Address - Phone:847-394-5304
Practice Address - Fax:847-394-5304
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0210011451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics