Individual
DR. JACK R LAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
105 MCCORT PL, JOHNSTOWN, PA 15904-1303
(814) 269-4404
(814) 266-8668
Mailing address
105 MCCORT PLACE, JOHNSTOWN, PA 15904
(814) 269-4404
(214) 266-8668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS021727L
PA
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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