Provider Demographics
NPI:1649090705
Name:LAZARO PASCUAL, ALBERTO (DDS, MSC)
Entity type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:
Last Name:LAZARO PASCUAL
Suffix:
Gender:M
Credentials:DDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 N ORLANDO AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-5432
Mailing Address - Country:US
Mailing Address - Phone:310-721-3205
Mailing Address - Fax:
Practice Address - Street 1:105 N ALMA DR STE 100
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3360
Practice Address - Country:US
Practice Address - Phone:972-727-5599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX-1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics