Organization
ST JOHNS MARSH DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORA LAZOVSKI DDS (VICE PRESIDENT)
(586) 716-4890
Entity
Organization
Contact information
Practice address
7213 DYKE RD, ALGONAC, MI 48001
(586) 716-4890
(586) 716-4892
Mailing address
7213 DYKE RD, ALGONAC, MI 48001
(586) 716-4890
(586) 716-4892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018006
MI
122300000X
Dentist
2901018071
MI
Other
Enumeration date
02/25/2008
Last updated
02/25/2008
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