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General NPI Number Information
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NPI Number | 1083068928
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Entity Type | Individual
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Provider Name | PAUL LAZARI DDS,MS
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Gender | Male
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 8 W CHESTNUT ST APT 26D
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City | CHICAGO
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State | IL
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Zip | 60610-3338
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Country | US
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Telephone | 408-781-2933
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Fax |
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Provider Business Mailing Address
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Address Line | 8 W CHESTNUT ST APT 26D
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City | CHICAGO
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State | IL
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Zip | 60610-3338
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Country | US
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Telephone | 408-781-2933
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 021002745
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019030331
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License Number State | IL
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