NPI 1063544039

David Robert Laste, DDS

Practitioner General Practice Dentistry Wauwatosa, WI

Practice location

Address: 11637 W North Ave, Wauwatosa, WI 53226-2129
Phone: (414) 259-0665
Fax: (414) 259-1057
Mailing address: 14600 Crestwood CT, Elm Grove, WI 53122-1601

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 5001793-015 (WI)

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Registry record

NPI: 1063544039
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.