Provider Demographics
NPI:1932348521
Name:SHEBER, LAWRENCE RANDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:RANDY
Last Name:SHEBER
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 1:5500-A LILBURN STONE MOUNTAIN ROAD
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087
Mailing Address - Country:US
Mailing Address - Phone:770-923-5500
Mailing Address - Fax:770-923-0044
Practice Address - Street 1:5500-A LILBURN STONE MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087
Practice Address - Country:US
Practice Address - Phone:770-923-5500
Practice Address - Fax:770-923-0044
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN008083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist