Organization
KEVIN M. LASSITER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN LASSITER DMD (OWNER)
(762) 444-1061
Entity
Organization
Contact information
Practice address
11130 N TATUM BLVD STE 103, PHOENIX, AZ 85028-1675
(602) 956-2260
Mailing address
3160 E FOX ST, MESA, AZ 85213-5418
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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