Doctor Name: | DR. JAMES B LAGO |
NPI Number: | 1508139635 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS/MD |
License Number: | 019021144 |
Business Practice Address: | 3 S. Prospect Park Ridge, IL - 600685014 |
Business Phone Number: | 8478233441 |
Business Fax Number: | |
Mailing Address: | 3 S. Prospect, PARK RIDGE |
State: | IL |
Postal Code: | 600685014 |
Phone Number: | 8478233441 |
Fax Number: | |
NPI Enumeration Date: | 02/21/2012 |
NPI Last Update Date: | 02/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204E00000X |
License Number: | 019021144 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Oral & Maxillofacial Surgery |
Taxonomy Specialization: | |
Taxonomy Definition: |