Provider Demographics
NPI:1124465752
Name:KAWA, LAWRENCE BRUCE (DDS)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:BRUCE
Last Name:KAWA
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 1:20423 STATE ROAD 7
Mailing Address - Street 2:STE F-18
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6797
Mailing Address - Country:US
Mailing Address - Phone:561-852-7070
Mailing Address - Fax:561-852-7520
Practice Address - Street 1:20423 STATE ROAD 7
Practice Address - Street 2:STE F-18
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6797
Practice Address - Country:US
Practice Address - Phone:561-852-7070
Practice Address - Fax:561-852-7520
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN131041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics