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Individual
JESSE LAWRENCE LANZON
Active
Individual
JESSE LAWRENCE LANZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
56306
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
A123328
CA
Other
Enumeration date
04/27/2007
Last updated
08/18/2013
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