Individual
ANDY LAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3900 W FULLERTON AVE, CHICAGO, IL 60647-2228
(770) 252-8000
Mailing address
430 S LINDEN AVE, WESTMONT, IL 60559-2042
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.035212
IL
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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