Provider Demographics
NPI:1952331357
Name:SYNER, LAWRENCE E (DDS)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:E
Last Name:SYNER
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 1:750 STANAFORD RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-8737
Mailing Address - Country:US
Mailing Address - Phone:304-252-8609
Mailing Address - Fax:304-253-8870
Practice Address - Street 1:750 STANAFORD RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-8737
Practice Address - Country:US
Practice Address - Phone:304-252-8609
Practice Address - Fax:304-253-8870
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18111223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0138270000Medicaid
WVSY0351213Medicare PIN
WVT82017Medicare UPIN