Provider Demographics
NPI:1841403508
Name:LASKIN, BRYAN NEIL (DDS)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:NEIL
Last Name:LASKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BUSHAWAY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1206
Mailing Address - Country:US
Mailing Address - Phone:952-475-0225
Mailing Address - Fax:952-475-0776
Practice Address - Street 1:109 BUSHAWAY RD STE 300
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-2079
Practice Address - Country:US
Practice Address - Phone:952-475-0225
Practice Address - Fax:952-475-0776
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice