Individual
DR. KEVIN LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
343 WARRIOR RD, BUILDING 2115, FORT STEWART, GA 31314
(912) 767-1536
Mailing address
343 WARRIOR RD, BLDG 2115, FORT STEWART, GA 31314
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D-4521
ID
1223P0700X
Prosthodontics
Primary
D-4521
ID
Other
Enumeration date
05/19/2014
Last updated
03/20/2023
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