Provider Demographics
NPI:1366587560
Name:LAWLER, DAVID ESTON (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ESTON
Last Name:LAWLER
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 1:2909 BUICK CADILLAC BLVD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-5443
Mailing Address - Country:US
Mailing Address - Phone:812-339-3427
Mailing Address - Fax:
Practice Address - Street 1:2909 BUICK CADILLAC BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-5443
Practice Address - Country:US
Practice Address - Phone:812-339-3427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12006868A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist