NPI 1740591890

Jesse David Laizure

Practitioner Dental Laboratory Technician Scottsdale, AZ

Practice location

Address: 15333 N Pima Rd Suite 103, Scottsdale, AZ 85260
Phone: (602) 298-1388
Fax: (602) 298-1391

Registered specialties

Dental Laboratory Technician Primary

Dental Providers Taxonomy 126900000X

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Registry record

NPI: 1740591890
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jun 2010
Record last updated: 23 Jun 2010

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.