Organization
DAVID R. LASTE D.D.S.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROBERT LASTE D.D.S. (PRESIDENT)
(414) 259-0665
Entity
Organization
Contact information
Practice address
11637 W NORTH AVE, WAUWATOSA, WI 53226-2129
(414) 259-0665
(262) 785-6242
Mailing address
11637 W NORTH AVE, WAUWATOSA, WI 53226-2129
(414) 259-0665
(262) 785-6242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001793-015
WI
Other
Enumeration date
09/14/2006
Last updated
08/22/2020
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