Individual
DR. GEORGE LAZOPOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
111 N CHURCH ST, ROCKFORD, IL 61101-1001
(815) 962-0394
(815) 962-5163
Mailing address
111 N CHURCH ST, ROCKFORD, IL 61101-1001
(815) 962-0394
(815) 962-5163
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002671
—
IL
Enumeration date
08/16/2006
Last updated
07/09/2007
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