Provider Demographics
NPI:1912540162
Name:LAZARI, ELENA (DMD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:LAZARI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:CUCEROV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38 MAIN ST APT 17
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-2221
Mailing Address - Country:US
Mailing Address - Phone:857-234-2743
Mailing Address - Fax:
Practice Address - Street 1:151 MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2725
Practice Address - Country:US
Practice Address - Phone:603-556-7043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04526122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist