| Doctor Name: | DR. JOHN PHILLIP LAVIERI |
| NPI Number: | 1467546689 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS |
| License Number: | |
| Business Practice Address: | 206 Marquette Street Suite 311 La Salle, IL - 613012483 |
| Business Phone Number: | 8152241988 |
| Business Fax Number: | 8152243220 |
| Mailing Address: | 206 Marquette Street, Suite 311 LA SALLE |
| State: | IL |
| Postal Code: | 613012483 |
| Phone Number: | 8152241988 |
| Fax Number: | 8152243220 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 04/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |