Provider Demographics
NPI:1942298658
Name:NURIN, LAWRENCE A (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:NURIN
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 1:101 RIDGELY AVE
Mailing Address - Street 2:SUITE 11A
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1409
Mailing Address - Country:US
Mailing Address - Phone:410-268-5103
Mailing Address - Fax:410-269-7992
Practice Address - Street 1:101 RIDGELY AVE
Practice Address - Street 2:SUITE 11A
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1409
Practice Address - Country:US
Practice Address - Phone:410-268-5103
Practice Address - Fax:410-269-7992
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD45041223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4893OtherBCBS
MD4893OtherBCBS