Provider Demographics
NPI:1689897571
Name:LASKO, BARRY J (DDS)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:J
Last Name:LASKO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:BARRY
Other - Middle Name:
Other - Last Name:LASKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:51 EAST LAKE MEAD PKWY
Mailing Address - Street 2:STE 102
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-6435
Mailing Address - Country:US
Mailing Address - Phone:702-564-1818
Mailing Address - Fax:702-565-4011
Practice Address - Street 1:51 E LAKE MEAD PKWY
Practice Address - Street 2:STE 102
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-6434
Practice Address - Country:US
Practice Address - Phone:702-564-1818
Practice Address - Fax:702-565-4011
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV25641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice