Provider Demographics
NPI:1851073688
Name:LASCH, JAIDIN DYLAN
Entity Type:Individual
Prefix:
First Name:JAIDIN
Middle Name:DYLAN
Last Name:LASCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 41 BOX 5669
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-0057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:944 RAF LAKENHEATH
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:BRANDON
Practice Address - Zip Code:IP27 9PN
Practice Address - Country:GB
Practice Address - Phone:742-844-9349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant