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Individual
DANIS LYLE LAIZURE
Active
Individual
DANIS LYLE LAIZURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD,FAGD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE0004946
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
911868526
T.I.N.
WA
01
—
DE0004946
STATE LICENSE
WA
Enumeration date
07/25/2006
Last updated
03/07/2023
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