Provider Demographics
NPI:1548257660
Name:DEHNER, LAWRENCE R (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:R
Last Name:DEHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:STE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:49 STATE ROAD, NAUSET BLDG
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3322
Practice Address - Country:US
Practice Address - Phone:508-973-9240
Practice Address - Fax:508-973-0306
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46121208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110002527AMedicaid
MA110002527AMedicaid
MA0130109Medicaid