Provider Demographics
NPI:1922129907
Name:LAWRENCE S. MILLER DMD PC
Entity Type:Organization
Organization Name:LAWRENCE S. MILLER DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-750-8828
Mailing Address - Street 1:156 ANDOVER ST
Mailing Address - Street 2:#220
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1468
Mailing Address - Country:US
Mailing Address - Phone:978-750-8828
Mailing Address - Fax:
Practice Address - Street 1:156 ANDOVER ST
Practice Address - Street 2:#220
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1468
Practice Address - Country:US
Practice Address - Phone:978-750-8828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA182901223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty