Provider Demographics
NPI:1528251204
Name:COFFIN, LAWRENCE KIRK JR (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:KIRK
Last Name:COFFIN
Suffix:JR
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 1:400 PIERSON RD
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8602
Mailing Address - Country:US
Mailing Address - Phone:717-615-2761
Mailing Address - Fax:
Practice Address - Street 1:300 HOTEL RD
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-9525
Practice Address - Country:US
Practice Address - Phone:717-520-2747
Practice Address - Fax:717-569-6433
Is Sole Proprietor?:No
Enumeration Date:2007-08-25
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS02712OL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice