Provider Demographics
NPI:1770214132
Name:LAWRENCE-PUMMILL, HALEY (DDS)
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:
Last Name:LAWRENCE-PUMMILL
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9254 MARLOWE AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4038
Mailing Address - Country:US
Mailing Address - Phone:734-679-8898
Mailing Address - Fax:
Practice Address - Street 1:7300 DEXTER ANN ARBOR RD
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-8598
Practice Address - Country:US
Practice Address - Phone:734-426-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016013961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice