# JOHN A LAZARUS DDS MS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568631489
- **Authorized official:** DR. JOHN A LAZARUS DDS MS (PRESIDENT OWNER)
- **Authorized official phone:** (248) 674-3136

## Contact information

- **Practice address:** 4250 PONTIAC LAKE RD, SUITE A, WATERFORD, MI 48328-1281
- **Practice address phone:** (248) 674-3136
- **Practice address fax:** (248) 674-3138
- **Mailing address:** 4250 PONTIAC LAKE RD, SUITE A, WATERFORD, MI 48328-1281
- **Mailing address phone:** (248) 674-3136
- **Mailing address fax:** (248) 674-3138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901009548 | MI | Yes |

## Other

- **Enumeration date:** 02/25/2008
- **Last updated:** 02/25/2008