Provider Demographics
NPI:1922154095
Name:LAGA, EDWARD AUGUST JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:AUGUST
Last Name:LAGA
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:175 ACADEMY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3103
Mailing Address - Country:US
Mailing Address - Phone:207-764-2600
Mailing Address - Fax:207-764-3788
Practice Address - Street 1:175 ACADEMY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3103
Practice Address - Country:US
Practice Address - Phone:207-764-3900
Practice Address - Fax:207-764-3788
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2008-05-21
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Provider Licenses
StateLicense IDTaxonomies
MEDEN40021223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery