Provider Demographics
NPI:1922115716
Name:KLEIN, LAWRENCE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:M
Last Name:KLEIN
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 1:7301A W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3409
Mailing Address - Country:US
Mailing Address - Phone:561-391-1114
Mailing Address - Fax:561-391-2944
Practice Address - Street 1:7301A W PALMETTO PARK RD
Practice Address - Street 2:SUITE 204A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3409
Practice Address - Country:US
Practice Address - Phone:561-391-1114
Practice Address - Fax:561-391-2944
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 79921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice