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Individual

DR. MARK DAVID LASSITER SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
8487 S SCENIC HWY, BLAND, VA 24315-4691
(276) 688-4711
(276) 688-4712
Mailing address
8487 S SCENIC HWY, BLAND, VA 24315-4691
(276) 688-4711
(276) 688-4712

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6451
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8995126
NC
Enumeration date
01/31/2007
Last updated
09/13/2024
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