Provider Demographics
NPI:1811047368
Name:HSIA, LAWRENCE (DMD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:HSIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 JUNE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3724
Mailing Address - Country:US
Mailing Address - Phone:901-761-1515
Mailing Address - Fax:901-761-2840
Practice Address - Street 1:1010 JUNE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3724
Practice Address - Country:US
Practice Address - Phone:901-761-1515
Practice Address - Fax:901-761-2840
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS39311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice