Provider Demographics
NPI:1104912195
Name:LAZAROW, ROBERT M
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:LAZAROW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2858 S ARLINGTON RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-4746
Mailing Address - Country:US
Mailing Address - Phone:330-644-0633
Mailing Address - Fax:330-644-0505
Practice Address - Street 1:2858 S ARLINGTON RD
Practice Address - Street 2:SUITE #200
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-4746
Practice Address - Country:US
Practice Address - Phone:330-644-0633
Practice Address - Fax:330-644-0505
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0146901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice