Provider Demographics
NPI:1912277096
Name:STEVE LAZAR DMD, P.C. DBA ADVANCED DENTISTRY
Entity Type:Organization
Organization Name:STEVE LAZAR DMD, P.C. DBA ADVANCED DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-476-2700
Mailing Address - Street 1:5731 S FORT APACHE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5666
Mailing Address - Country:US
Mailing Address - Phone:702-476-2700
Mailing Address - Fax:702-476-2730
Practice Address - Street 1:5731 SOUTH FORT APACHE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5666
Practice Address - Country:US
Practice Address - Phone:702-476-2700
Practice Address - Fax:702-476-2730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4414261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental