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Individual

DR. JEREMY LASSETTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
5 PALISADES DR, SUITE 210, ALBANY, NY 12205-6433
(518) 348-0634
(518) 426-3221
Mailing address
5 PALISADES DR, SUITE 210, ALBANY, NY 12205-6433
(518) 348-0634
(518) 426-3221

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8682
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
055974
NY

Other

Enumeration date
08/06/2007
Last updated
10/16/2013
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