Provider Demographics
NPI:1063754984
Name:MEEKMA, LAWRENCE J (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:MEEKMA
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 1:7400 W COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1155
Mailing Address - Country:US
Mailing Address - Phone:708-448-3399
Mailing Address - Fax:708-448-2646
Practice Address - Street 1:7400 W COLLEGE DR
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1155
Practice Address - Country:US
Practice Address - Phone:708-448-3399
Practice Address - Fax:708-448-2646
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0156691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice