Organization Name: | WILLIAM M LAWLEY DDS LTD |
NPI Number: | 1033363304 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM LAWLEY (PRESIDENT) |
Mailing Address: | 10704 31st St Westchester |
State: | IL US |
Postal Code: | 601545111 |
Phone Number: | 7084090990 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2008 |
NPI Last Update Date: | 12/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 1917431 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |