| David R. Laste D.d.s.,s.c. | |
|
11637 W North Ave Wauwatosa WI 53226-2129 | |
| (414) 259-0665 | |
| (262) 785-6242 |
| Full Name | David R. Laste D.d.s.,s.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11637 W North Ave, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | David Robert Laste (PRESIDENT) |
| Authorized Official Contact | 4142590665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David R. Laste D.d.s.,s.c. 11637 W North Ave Wauwatosa WI 53226-2129 Ph: (414) 259-0665 | David R. Laste D.d.s.,s.c. 11637 W North Ave Wauwatosa WI 53226-2129 Ph: (414) 259-0665 |
| NPI Number | 1528163169 |
|---|---|
| Provider Enumeration Date | 09/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528163169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5001793-015 (Wisconsin) | Primary |
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