Provider Demographics
NPI:1124016704
Name:LASKER, JOHN JR
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:LASKER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1900
Mailing Address - Country:US
Mailing Address - Phone:617-489-1232
Mailing Address - Fax:617-489-1893
Practice Address - Street 1:6 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1900
Practice Address - Country:US
Practice Address - Phone:617-489-1232
Practice Address - Fax:617-489-1893
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice