Provider Demographics
NPI:1659390375
Name:GILBERT, LAWRENCE (DDS)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:GILBERT
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 1:505 STATE ROUTE 208
Mailing Address - Street 2:SUITE 23
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1608
Mailing Address - Country:US
Mailing Address - Phone:845-783-8326
Mailing Address - Fax:845-783-0116
Practice Address - Street 1:505 STATE ROUTE 208
Practice Address - Street 2:SUITE 23
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1608
Practice Address - Country:US
Practice Address - Phone:845-783-8326
Practice Address - Fax:845-783-0116
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0300771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice