Individual
MICHAEL DONALD LASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
607 W ORCHARD ST, A, VANDALIA, IL 62471-1234
(618) 283-2929
Mailing address
607 W ORCHARD ST, A, VANDALIA, IL 62471-1234
(618) 283-2929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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