Provider Demographics
NPI:1245435601
Name:LAWLEY, GEORGE ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ROBERT
Last Name:LAWLEY
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 1:748 STATE ROUTE 28
Mailing Address - Street 2:SUITE C
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1802
Mailing Address - Country:US
Mailing Address - Phone:513-248-0300
Mailing Address - Fax:513-248-1980
Practice Address - Street 1:748 STATE ROUTE 28
Practice Address - Street 2:SUITE C
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1802
Practice Address - Country:US
Practice Address - Phone:513-248-0300
Practice Address - Fax:513-248-1980
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-204801223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics