Provider Demographics
NPI:1487738993
Name:KNIGHT, LAWRENCE DOUGLAS (DMD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:DOUGLAS
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:L
Other - Middle Name:DOUGLAS
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD PSC
Mailing Address - Street 1:3210 WESTPORT GREEN PLACE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241
Mailing Address - Country:US
Mailing Address - Phone:502-327-6453
Mailing Address - Fax:502-327-8385
Practice Address - Street 1:3210 WESTPORT GREEN PLACE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241
Practice Address - Country:US
Practice Address - Phone:502-327-6453
Practice Address - Fax:502-327-8385
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY65141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics