Provider Demographics
NPI:1861586984
Name:DREXLER, LAURENCE E (DMD)
Entity type:Individual
Prefix:MISS
First Name:LAURENCE
Middle Name:E
Last Name:DREXLER
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 1:7835 WOODMERE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-6682
Mailing Address - Country:US
Mailing Address - Phone:704-455-2706
Mailing Address - Fax:
Practice Address - Street 1:1000 N 1ST ST
Practice Address - Street 2:SUITE #3
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2833
Practice Address - Country:US
Practice Address - Phone:704-986-3845
Practice Address - Fax:704-986-3847
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17271223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC902PMMedicaid