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Individual

FEDERICO FABIAN LAGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1 ROOSEVELT AVE, PEABODY, MA 01960-2200
(978) 535-2500
Mailing address
1005 TRAPELO RD APT 4, WALTHAM, MA 02452-4875
(917) 626-1105

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
20795
MA

Other

Enumeration date
05/17/2007
Last updated
07/08/2007
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