Provider Demographics
NPI:1720113426
Name:SKLAR, LAWRENCE (DDS)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:SKLAR
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 1:27281 W WARREN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1804
Mailing Address - Country:US
Mailing Address - Phone:313-274-4040
Mailing Address - Fax:313-274-8080
Practice Address - Street 1:27281 W WARREN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1804
Practice Address - Country:US
Practice Address - Phone:313-274-4040
Practice Address - Fax:313-274-8080
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010141391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice