Provider Demographics
NPI:1184997207
Name:LAWSON, MICHAEL EMIL (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EMIL
Last Name:LAWSON
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 1:2395 TROOP DR
Mailing Address - Street 2:101
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-4694
Mailing Address - Country:US
Mailing Address - Phone:320-252-6191
Mailing Address - Fax:320-253-8974
Practice Address - Street 1:2395 TROOP DR
Practice Address - Street 2:101
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4694
Practice Address - Country:US
Practice Address - Phone:320-252-6191
Practice Address - Fax:320-253-8974
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND112311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice