Provider Demographics
NPI:1891858080
Name:AMSTERDAM, LAWRENCE ABRAHAM (DMD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ABRAHAM
Last Name:AMSTERDAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 COUNTRY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3906
Mailing Address - Country:US
Mailing Address - Phone:410-574-1555
Mailing Address - Fax:410-574-8483
Practice Address - Street 1:1528 COUNTRY RIDGE LN
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-3906
Practice Address - Country:US
Practice Address - Phone:410-574-1555
Practice Address - Fax:410-574-8483
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD067421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice