Provider Demographics
NPI:1912900564
Name:LASK, ANDREW J (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:LASK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 RAEMONT RD.
Mailing Address - Street 2:
Mailing Address - City:GRANITE SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:10527
Mailing Address - Country:US
Mailing Address - Phone:914-248-7353
Mailing Address - Fax:
Practice Address - Street 1:66 MILTON RD.
Practice Address - Street 2:A13
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580
Practice Address - Country:US
Practice Address - Phone:914-967-1123
Practice Address - Fax:914-967-2776
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0319911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY031991OtherLICENSE NUMBER
AL6895948OtherDEA