Provider Demographics
NPI:1124457403
Name:SARKIS, LAWRENCE JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JOSEPH
Last Name:SARKIS
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 1:102 S WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366-2753
Mailing Address - Country:US
Mailing Address - Phone:209-599-4176
Mailing Address - Fax:209-599-4178
Practice Address - Street 1:102 S WALNUT AVE
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-2753
Practice Address - Country:US
Practice Address - Phone:209-599-4176
Practice Address - Fax:209-599-4178
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist