Provider Demographics
NPI:1902914492
Name:LAW, DAVID LAWAYNE (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LAWAYNE
Last Name:LAW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016
Mailing Address - Country:US
Mailing Address - Phone:256-586-6120
Mailing Address - Fax:256-586-6975
Practice Address - Street 1:320 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016
Practice Address - Country:US
Practice Address - Phone:256-586-6120
Practice Address - Fax:256-586-6975
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4716122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist