Provider Demographics
NPI:1982782561
Name:LAWSON, STEPHEN GLENN (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GLENN
Last Name:LAWSON
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 1:34-36 PROGRESS STREET
Mailing Address - Street 2:TWIN PLAZA, SUITE A-3
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:908-753-6060
Mailing Address - Fax:
Practice Address - Street 1:34-36 PROGRESS STREET
Practice Address - Street 2:TWIN PLAZA, SUITE A-3
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:908-753-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ182381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics