Provider Demographics
NPI:1760579403
Name:LASSER, STEVEN DENNIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DENNIS
Last Name:LASSER
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 1:245 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5730
Mailing Address - Country:US
Mailing Address - Phone:401-274-3523
Mailing Address - Fax:
Practice Address - Street 1:1090 NEW LONDON AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-3035
Practice Address - Country:US
Practice Address - Phone:401-943-7535
Practice Address - Fax:401-463-5693
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI17261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIPD-00520Medicaid