Provider Demographics
NPI:1649351875
Name:HATFIELD, LAWRENCE J JR (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:HATFIELD
Suffix:JR
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 1:220 W GUADALUPE ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-1926
Mailing Address - Country:US
Mailing Address - Phone:979-206-2221
Mailing Address - Fax:979-206-2225
Practice Address - Street 1:220 W GUADALUPE ST
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-1926
Practice Address - Country:US
Practice Address - Phone:979-206-2221
Practice Address - Fax:979-206-2225
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13463122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist