Stephen Mark Lawrence, D.M.D
Individual provider Active NPI General Practice Dentistry · Forty Fort, PA
NPI 1841334869 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1841334869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 021791-L (PA)
- Practice address
- 1500 Wyoming Ave
Forty Fort, PA 18704-4219 - Phone
- (570) 288-5588
- Fax
- (507) 288-4345
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170217000507 | PA | Order and Referring Only - Dentist |
7810270881 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021791-L | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen M. Lawrence ,DMD, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 021791-L | PA | Yes |
Addresses
Primary practice location
1500 Wyoming Ave
Forty Fort, PA 18704-4219
Mailing address
1500 Wyoming Ave
Forty Fort, PA 18704-4219
Phone (570) 288-5588
Other providers in Forty Fort, PA
- Ron Konecke
- Levi Adam Koral
- Anne Larson
- Laser and Cosmetic Surgeons PC
- Casey Laskaris
- Elizabeth Leake
- Gerald J Levandoski
- Gina Elizabeth Lispi-Murray
- Awathif Dhanya Mackeen
- Paul Raymond Mahler Jr.
All providers in Forty Fort, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.