Provider Demographics
NPI:1982859112
Name:ROBERT S.LASH, D.D.S.
Entity Type:Organization
Organization Name:ROBERT S.LASH, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:LASH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-291-8630
Mailing Address - Street 1:10409 MONTGOMERY PKWY NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3852
Mailing Address - Country:US
Mailing Address - Phone:505-291-8630
Mailing Address - Fax:505-292-7563
Practice Address - Street 1:10409 MONTGOMERY PKWY NE
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3852
Practice Address - Country:US
Practice Address - Phone:505-291-8630
Practice Address - Fax:505-292-7563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD14871223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty