Provider Demographics
NPI:1770628372
Name:PETER J LASCHEID, DDS
Entity Type:Organization
Organization Name:PETER J LASCHEID, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LASCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-546-8515
Mailing Address - Street 1:10730 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-4920
Mailing Address - Country:US
Mailing Address - Phone:772-546-8515
Mailing Address - Fax:772-546-8533
Practice Address - Street 1:10730 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-4920
Practice Address - Country:US
Practice Address - Phone:772-546-8515
Practice Address - Fax:772-546-8533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty