Provider Demographics
NPI:1871858308
Name:SCHLACHTER, LAWRENCE BERNARD (DDS MD JD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:BERNARD
Last Name:SCHLACHTER
Suffix:
Gender:M
Credentials:DDS MD JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 STONEMOOR CIR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2279
Mailing Address - Country:US
Mailing Address - Phone:770-640-1702
Mailing Address - Fax:404-506-9581
Practice Address - Street 1:540 STONEMOOR CIR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2279
Practice Address - Country:US
Practice Address - Phone:770-640-1702
Practice Address - Fax:404-506-9581
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018736208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA018736OtherPHYSICIAN