# DR. AMANDA BRANNAN LAZO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1073873162
- **Gender:** F
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401415059 | VA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NE | — |

## Other

- **Enumeration date:** 05/22/2012
- **Last updated:** 06/09/2016