Provider Demographics
NPI:1528851847
Name:BENNETT, LAURENCE T (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:T
Last Name:BENNETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:LANCE
Other - Middle Name:T
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:21409 SE 134TH ST
Mailing Address - Street 2:
Mailing Address - City:MCLOUD
Mailing Address - State:OK
Mailing Address - Zip Code:74851-8722
Mailing Address - Country:US
Mailing Address - Phone:405-308-6499
Mailing Address - Fax:
Practice Address - Street 1:3401 W TECUMSEH RD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1809
Practice Address - Country:US
Practice Address - Phone:405-400-1745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK80181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice