Provider Demographics
NPI:1700948429
Name:GUNN, LAWSON WAITE (DDS,)
Entity Type:Individual
Prefix:DR
First Name:LAWSON
Middle Name:WAITE
Last Name:GUNN
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 1:483 BOSTON NECK RD
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3104
Mailing Address - Country:US
Mailing Address - Phone:401-789-5511
Mailing Address - Fax:401-789-8865
Practice Address - Street 1:483 BOSTON NECK RD
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3104
Practice Address - Country:US
Practice Address - Phone:401-789-5511
Practice Address - Fax:401-789-8865
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI20511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0056OtherBCMA
RI200-2051OtherDDRI
RI8963OtherBCBSRI
RI614485OtherUNITED CONCORDIA
RILG28238OtherEDS