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General NPI Number Information
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NPI Number | 1700952041
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Entity Type | Organization
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Legal Business Name | DENNIS J LAZZARA DDS MS LTD
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1129 RANDALL COURT
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City | GENEVA
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State | IL
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Zip | 60134-3911
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Country | US
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Telephone | 630-232-2277
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Fax | 630-232-0354
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Provider Business Mailing Address
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Address Line | 1129 RANDALL COURT
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City | GENEVA
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State | IL
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Zip | 60134-3911
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Country | US
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Telephone | 630-232-2277
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Fax | 630-232-0354
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Authorized Official
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Title or Position | ORTHODONTIST PRESIDENT
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Name | DR. DENNIS J LAZZARA
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Credential | DDS MS
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Telephone | 630-232-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | IL
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