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NPI Code Detail

MEDICARE: DR. MILES D LAZERWITZ DDS

MEDICARE: DR. MILES D LAZERWITZ DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry6165NJ

General Provider Information

NPI Number : 1134123631
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MILES D LAZERWITZ DDS
Provider Business Mailing Address
First Line : 179 S MAPLE AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-4541
Country : US
Telephone Number : 201-447-4424
Fax Number :
Provider Business Practice Location Address
First Line : 179 S MAPLE AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-4541
Country : US
Telephone Number : 201-447-4424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/08/2007

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