Individual
DR. MICHAEL RANDOLPH LAZEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8134 OLD KEENE MILL RD, SUITE 203, SPRINGFIELD, VA 22152-1800
(703) 569-2080
Mailing address
6209 THOMAS DR, SPRINGFIELD, VA 22150-1221
(703) 282-4642
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401-411826
VA
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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