Healthcare Provider Details

I. General information

NPI: 1316163793
Provider Name (Legal Business Name): FRANK A.LASLEY, III DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WINN ST
BURLINGTON MA
01803-4701
US

IV. Provider business mailing address

2 WINN ST
BURLINGTON MA
01803-4701
US

V. Phone/Fax

Practice location:
  • Phone: 781-272-4200
  • Fax: 781-272-2683
Mailing address:
  • Phone: 781-272-4200
  • Fax: 781-272-2683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10849
License Number StateMA

VIII. Authorized Official

Name: DR. FRANK ANDREW LASLEY III
Title or Position: OWNER
Credential: DDS
Phone: 781-272-4200