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Individual

DR. GARY MARK LAZAROFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
257 WAYLAND AVENUE, PROVIDENCE, RI 02906
(401) 272-1380
(401) 272-1387
Mailing address
257 WAYLAND AVENUE, PROVIDENCE, RI 02906
(401) 272-1380
(401) 272-1387

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1815
RI

Other

Enumeration date
04/10/2007
Last updated
07/08/2007
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