Provider Demographics
NPI:1265764609
Name:NAKAMURA, LAWRENCE HARUO (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:HARUO
Last Name:NAKAMURA
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 1:1622 POST ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3604
Mailing Address - Country:US
Mailing Address - Phone:415-567-5200
Mailing Address - Fax:415-567-0777
Practice Address - Street 1:1622 POST ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3604
Practice Address - Country:US
Practice Address - Phone:415-567-5200
Practice Address - Fax:415-567-0777
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADT034743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist