Provider Demographics
NPI:1972510550
Name:LAWR, MICHAEL W (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:LAWR
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 1:111 BROADWAY AVE E
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-3703
Mailing Address - Country:US
Mailing Address - Phone:360-249-5100
Mailing Address - Fax:360-249-6516
Practice Address - Street 1:111 BROADWAY AVE E
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-3703
Practice Address - Country:US
Practice Address - Phone:360-249-5100
Practice Address - Fax:360-249-6516
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA57241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice