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Individual

DR. HARIS LAKISIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
5565 GROSSMONT CENTER DR, LA MESA, CA 91942-3020
(619) 464-3383
(619) 464-2589
Mailing address
PO BOX 17179, IRVINE, CA 92623-7179
(949) 567-3176
(949) 567-3185

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
53236
CA

Other

Enumeration date
11/07/2006
Last updated
07/08/2007
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