Provider Demographics
NPI:1386647386
Name:LASKY, ANDREW MARC (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MARC
Last Name:LASKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 18TH ST NW
Mailing Address - Street 2:STE 201
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-6501
Mailing Address - Country:US
Mailing Address - Phone:202-463-6148
Mailing Address - Fax:202-887-5173
Practice Address - Street 1:1325 18TH ST NW
Practice Address - Street 2:STE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6501
Practice Address - Country:US
Practice Address - Phone:202-463-6148
Practice Address - Fax:202-887-5173
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCDEN3418122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist